Systemic Treatment of Recurrent Meningioma

European Association of NeuroOncology Magazine 2013; 3 (3): 132-138

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Keywords: chemotherapy,  hormonal therapy,  immunotherapy,  meningioma,  neuro-oncology,  systemic treatment,  targeted therapy

Meningioma is the most frequently diagnosed primary brain tumour. Although only a subset of meningioma patients suffer recurrence after standard therapy, these patients require further rescue treatment. Owing to the fact that meningioma over-expresses a great number of potential therapeutic targets, some systemic therapies have been evaluated in recurrent meningioma patients. Cytostatic agents, including combined chemotherapeutic regimens, hydroxyurea and temozolomide, are generally ineffective. Immunotherapy and hormonal therapy with somatostatin analogues have been suggested as potential therapeutic agents, even though studies have presented contradictory results. Recently, several studies using targeted therapies, such as epidermal growth factor receptor (EGFR), platelet-derived growth factor receptor (PDGFR), and vascular endothelial growth factor (VEGF) inhibitors, showed early promising results. However, additional long-term results are still under evaluation. Furthermore, the combination of various medical therapies, such as hydroxyurea and a PDGFR inhibitor, appears to hold some promise. This review provides an overview of the current rationale and evidence base for the various medical therapy approaches tested.