Multimodal management of surgery- and radiation-refractory meningiomas: an analysis of the French national tumor board meeting on meningiomas cohort
Tuan Le Van
(1)
,
Thomas Graillon
(2)
,
Julian Jacob
(3)
,
Elodie Vauleon
(4, 5)
,
Loic Feuvret
(3)
,
Anne-Laure Boch
(3)
,
Julien Boetto
(6, 7)
,
Mathieu Boone
(8)
,
Charlotte Bronnimann
(9)
,
François Caire
(10)
,
Amaury de Barros
(11)
,
Mariette Delaitre
(12)
,
Anna Luisa Di Stefano
(13)
,
Mélanie Dore
(14)
,
François Ducray
(15)
,
Christelle Dufour
(16, 17)
,
Julien Engelhardt
(18)
,
Denys Fontaine
(19)
,
Sebastien Froelich
(20)
,
Matthieu Helleringer
(21)
,
Aymeri Huchet
(9)
,
Anthony Joncour
(22)
,
Emmanuel Jouanneau
(15)
,
Charles-Henry Mallereau
(23)
,
Apolline Monfilliette
(24)
,
Emmanuelle Le Fur
(25)
,
Ilyess Zemmoura
(26)
,
O. Chinot
(2)
,
Marc Sanson
(3)
,
Michel Kalamarides
(3)
,
Hugues Loiseau
(19)
,
Matthieu Peyre
(3)
1
CHU Dijon -
Centre Hospitalier Universitaire de Dijon - Hôpital François Mitterrand
2 TIMONE - Hôpital de la Timone [CHU - APHM]
3 CHU Pitié-Salpêtrière [AP-HP]
4 COSS - Chemistry, Oncogenesis, Stress and Signaling
5 CRLCC - CRLCC Eugène Marquis
6 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
7 IGF - Institut de Génomique Fonctionnelle
8 CHU Amiens-Picardie
9 CHU Bordeaux - Centre Hospitalier Universitaire de Bordeaux
10 CHU Limoges
11 CIC 1436 - Centre d'investigation clinique de Toulouse
12 Hôpital pasteur [Colmar]
13 Hôpital Foch [Suresnes]
14 UNICANCER/ICO - Institut de Cancérologie de l'Ouest [Angers/Nantes]
15 HCL - Hospices Civils de Lyon
16 IGR - Institut Gustave Roussy
17 Département de cancérologie de l'enfant et de l'adolescent [Gustave Roussy]
18 IMOTION - Imagerie moléculaire et thérapies innovantes en oncologie
19 CHU Nice - Centre Hospitalier Universitaire de Nice
20 Hôpital Lariboisière-Fernand-Widal [APHP]
21 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
22 CHU de Poitiers [La Milétrie] - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
23 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
24 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
25 CH Saint-Brieuc - Centre hospitalier de Saint-Brieuc [Hôpital Yves Le Foll]
26 CHU Trousseau [Tours]
2 TIMONE - Hôpital de la Timone [CHU - APHM]
3 CHU Pitié-Salpêtrière [AP-HP]
4 COSS - Chemistry, Oncogenesis, Stress and Signaling
5 CRLCC - CRLCC Eugène Marquis
6 CHRU Montpellier - Centre Hospitalier Régional Universitaire [Montpellier]
7 IGF - Institut de Génomique Fonctionnelle
8 CHU Amiens-Picardie
9 CHU Bordeaux - Centre Hospitalier Universitaire de Bordeaux
10 CHU Limoges
11 CIC 1436 - Centre d'investigation clinique de Toulouse
12 Hôpital pasteur [Colmar]
13 Hôpital Foch [Suresnes]
14 UNICANCER/ICO - Institut de Cancérologie de l'Ouest [Angers/Nantes]
15 HCL - Hospices Civils de Lyon
16 IGR - Institut Gustave Roussy
17 Département de cancérologie de l'enfant et de l'adolescent [Gustave Roussy]
18 IMOTION - Imagerie moléculaire et thérapies innovantes en oncologie
19 CHU Nice - Centre Hospitalier Universitaire de Nice
20 Hôpital Lariboisière-Fernand-Widal [APHP]
21 CHRU Tours - Centre Hospitalier Régional Universitaire de Tours
22 CHU de Poitiers [La Milétrie] - Centre hospitalier universitaire de Poitiers = Poitiers University Hospital
23 CHU Strasbourg - Centre Hospitalier Universitaire [Strasbourg]
24 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
25 CH Saint-Brieuc - Centre hospitalier de Saint-Brieuc [Hôpital Yves Le Foll]
26 CHU Trousseau [Tours]
Thomas Graillon
- Fonction : Auteur
- PersonId : 16770
- IdHAL : thomas-graillon
- ORCID : 0000-0001-5627-8181
- IdRef : 161600131
Elodie Vauleon
- Fonction : Auteur
- PersonId : 765514
- ORCID : 0000-0001-9019-9778
- IdRef : 113696876
Mathieu Boone
- Fonction : Auteur
- PersonId : 1149851
- ORCID : 0009-0006-7248-7753
- IdRef : 157767957
Amaury de Barros
- Fonction : Auteur
- PersonId : 1286498
- ORCID : 0000-0001-9724-8616
- IdRef : 256950172
François Ducray
- Fonction : Auteur
- PersonId : 760118
- ORCID : 0000-0002-8150-5785
Christelle Dufour
- Fonction : Auteur
- PersonId : 762019
- ORCID : 0000-0001-5993-8077
Emmanuel Jouanneau
- Fonction : Auteur
- PersonId : 1258875
- ORCID : 0000-0003-2506-3430
- IdRef : 097548014
O. Chinot
- Fonction : Auteur
- PersonId : 172185
- IdHAL : olivier-chinot
- IdRef : 034791205
Marc Sanson
- Fonction : Auteur
- PersonId : 760119
- ORCID : 0000-0002-1813-8476
Michel Kalamarides
- Fonction : Auteur
- PersonId : 767013
- ORCID : 0000-0003-1037-9707
Résumé
PURPOSE: Meningiomas represent the most frequent tumor of the central nervous system in adults. While most meningiomas are efficiently treated by surgery and radiotherapy/radiosurgery, there is a small portion of radiation- and surgery-refractory tumors for which there is no clear recommendation for optimal management. The French National Tumor Board Meeting on Meningiomas (NTBM) offers a glimpse on the current management of such patients. METHODS: We retrospectively reviewed the charts of patients presented to the multidisciplinary Meeting between 2016 and 2019. We selected patients with a progressive disease after at least two treatments, including surgery and radiotherapy. RESULTS: In this multicentric cohort of 86 cases, patients harbored 17 (19.8%) WHO Grade I, 48 (55.8%) WHO Grade II and 21 (24.4%) WHO Grade III tumors. The median number of treatments received before inclusion was 3 (range: 2 - 11). Following the Board Meeting, 32 patients (37.2%) received chemotherapy, 11 (12.8%) surgery, 17 (19.8%) radiotherapy, 14 (16.3%) watchful observation and 12 (13.9%) palliative care. After a mean follow-up of 13 months post-inclusion, 32 patients (37.2%) had died from their disease. The mean progression free survival was 27 months after radiotherapy, 10 months after surgery, 8.5 months after chemotherapy (Bevacizumab: 9 months - Octreotide/Everolimus: 8 months). CONCLUSIONS: Surgery- and radiation-refractory meningiomas represent a heterogeneous group of tumors with a majority of WHO Grade II cases. If re-irradiation and redo-surgery are not possible, bevacizumab and octreotide-everolimus appear as a valuable option in heavily pre-treated patients considering the current EANO guidelines.