Interferon-alpha for recurrent World Health Organization grade 1 intracranial meningiomas.
الكلمات الدالة
نبذة مختصرة
BACKGROUND
Intracranial meningiomas are common, they frequently recur after surgery or radiotherapy, and there are limited data regarding the treatment of intracranial meningiomas with chemotherapy. A phase 2 study was designed to estimate the 6-month progression-free survival of patients with recurrent, treatment-refractory, World Health Organization grade 1 meningiomas who were treated with interferon-alpha.
METHODS
Thirty-five patients with recurrent meningiomas ranging in age from 36 years to 88 years (median age, 61 years) were treated according to a prospective phase 2 study. All patients had received prior surgery, radiotherapy, (involved-field radiotherapy in 35 patients andstereotactic radiotherapy in 22 patients), and chemotherapy (hydroxyurea in 19 patients and other in 17 patients). On radiographic documentation of progressive disease, interferon-alpha (at a dose of 10 million U/m(2) administered subcutaneously every other day) was initiated. A complete blood count and chemistry panel was obtained before every cycle, and cranial magnetic resonance images were obtained every 3 months.
RESULTS
The most common grade 3 and 4 toxicities were fatigue (6 patients; 17%), anemia (3 patients; 8.6%), and leukopenia (3 patients; 8.6%) (toxicities were graded according to the National Cancer Institute's Common Toxicity Criteria [version 3.0]). Three patients went off study because of toxicity, and 7 patients required a dose reduction. There were no treatment-related deaths or delays in therapy reported. All patients were assessable for response. No patient demonstrated a neuroradiographic complete or partial response. Twenty-six patients demonstrated stable disease after the first 3 cycles of interferon-alpha, and 9 patients had progressive disease. The progression-free survival rate was 54% at 6 months and 31% at 12 months. The median time to tumor progression was 7 months (range, 2-24 months). The median survival was 8 months (range, 3-28 months).
CONCLUSIONS
Treatment with interferon-alpha for recurrent meningiomas was found to be tolerated moderately well and was modestly effective.