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Mifepristone (RU 486) treatment of meningiomas
S W Lamberts1, H L Tanghe, C J Avezaat
1Erasmus University, Rotterdam, The Netherlands.
Abstract:
Meningiomas are common brain tumours which are generally benign, well circumscribed and slow growing. In a minority of patients complete surgical removal is not possible and re-growth of tumour tissue is a major clinical problem. Most meningiomas contain progesterone receptors. The anti-progestational drug mifepristone (RU 486) binds to these receptors. Ten patients were treated with 12 recurrent or primary "inoperable" meningiomas, all of whom had shown recent neuroradiological and/or ophthalmological evidence of tumour growth. They received 200 mg mifepristone daily for 12 months. Most patients initially had complaints of nausea, vomiting and/or tiredness. In four patients prednisone (7.5 mg/day) was given after which these side-effects subsided. CT scan analysis of tumour size, showed progression of growth of five meningiomas in four patients, stable disease in three patients with three tumours and regression of four tumours in three patients. A decrease in the complaints of headache and an improved general well being was observed in five patients. Two patients died during the treatment period from unrelated causes. Mifepristone treatment resulted in control of tumour growth (= stable disease) in six of 10 patients who had shown recent evidence of tumour growth. In three of these six patients consistent tumour shrinkage was observed.
Insights
Mifepristone (RU 486) was tested on 10 patients with inoperable brain tumors called meningiomas. The drug controlled tumor growth in six patients, with three showing shrinkage.
Area of Science:
- Neuro-oncology
- Endocrinology
Background:
- Meningiomas are common, typically benign brain tumors.
- Recurrent or inoperable meningiomas pose significant clinical challenges.
- Progesterone receptors are present in most meningiomas.
Purpose of the Study:
- To evaluate the efficacy of mifepristone, an anti-progestational drug, in treating recurrent or inoperable meningiomas.
- To assess the impact of mifepristone on tumor growth and patient symptoms.
Main Methods:
- Ten patients with 12 inoperable meningiomas received 200 mg of mifepristone daily for 12 months.
- Tumor size was monitored using CT scans.
- Patient-reported symptoms and side effects were recorded.
Main Results:
- Tumor growth control (stable disease) was achieved in 6 out of 10 patients.
- Tumor shrinkage was observed in 3 of the 6 patients with controlled growth.
- Five patients reported decreased headaches and improved well-being.
- Common side effects included nausea, vomiting, and tiredness, which were managed with prednisone.
Conclusions:
- Mifepristone demonstrates potential in controlling the growth of inoperable meningiomas.
- Further research is warranted to explore mifepristone's therapeutic role in neuro-oncology.
