Interferon-alpha for recurrent World Health Organization grade 1 intracranial meningiomas

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.

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.

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).

Treatment with interferon-alpha for recurrent meningiomas was found to be tolerated moderately well and was modestly effective.