Background. Despite advances in our understanding of the molecular underpinnings of meningioma progressionand innovations in systemic and local treatments, recurrent meningiomas remain a substantial therapeutic challenge.The objective of this systematic review and meta-analysis is to provide a historical baseline, contemporaryanalysis, and propose a “rate of probable interest” to inform future clinical trial design and development on behalfof the Response Assessment in Neuro-Oncology meningioma group.Methods. PubMed, ClinicalTrials.gov, and ASCOpubs databases were screened for clinical trials evaluating theactivity of systemic therapies for adults with recurrent meningiomas. The pooled progression-free survival at6-months and 1-year (PFS-6 and PFS-1 year) values were calculated using the random effects technique withI2 indices.Results. The pooled PFS-6 and PFS-1 year rates for recurrent WHO grade 1 meningiomas were 43.6% (95% CI:22.7-67.0%, I2 = 80%) and 21.7% (95% CI: 6.2-53.9%, I2 = 76%), and for grades 2-3 meningiomas, the PFS-6 was 38.0%(95% CI: 28.3-48.8%, I2 = 68%). In the targeted therapy group, PFS-6 and PFS-1 year rates stood at 62.0% (I2 = 58%)and 49.0% (I2 = 63%) for grade 1, while for grades 2-3 tumors, the PFS-6 rates with targeted therapy and immunotherapywere 42.1% (I² = 60%) and 46.0% (I² = 0%), respectively. The benchmarks were set at 67% and 54% for PFS-6and PFS-1 year for grade 1 tumors, and PFS-6 of 49% for grades 2-3 tumors.Conclusions. Several studies have reported outcomes in patients with recurrent meningiomas testing a variety ofagents with modest, but variable and progressively increasing activity. In this context, we recommend new benchmarksfor future trials to define efficacy of future investigational therapies.
Kotecha et al. (Wed,) studied this question.
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