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Published on: October 27, 2014
Immune checkpoint inhibitor therapy for recurrent meningiomas: a retrospective chart review
Priya Nidamanuri1, Jan Drappatz2
1Department of Neurology, Division of Hematology-Oncology, University of Pittsburgh Medical Center, 5115 Centre Avenue, Pittsburgh, PA, 15232, USA. nidamanurip2@upmc.edu.
Introduction:
Meningiomas that progress despite surgery and radiotherapy represent an unmet medical need. Expression of PD-1 and PDL-1 has been demonstrated in meningiomas and is proportional to tumor grade, suggesting a potential role for anti-PD-1/anti-PDL-1 inhibitor therapy. We explored the potential role of immunotherapy for recurrent meningiomas by describing progression-free survival (PFS) and overall survival (OS) in a single-center patient sample.
Methods:
This is a retrospective chart review of patients with meningioma who were treated with PD-1 inhibitors at UPMC Hillman Cancer Center. Any patient over age 18 who received immunotherapy was included in this study. Patients received treatment until development of disease progression, intolerable toxicities or adverse events, death, or oncologist decision. Serial radiographic assessments were made every 3-6 months.
Results:
Between January 2015 and November 2021, eight patients received anti-PD-1 therapy. All patients underwent tumor resection and radiosurgery, and four patients received prior systemic therapy. Six out of eight patients experienced symptomatic perilesional edema and three patients experienced exacerbation of seizures. Median PFS was 7 months (95% CI 1-24) and median OS was 1.75 years (95% CI 1.5-4.0). In patients with positive PD-1/PD-L1 expression, median PFS was 2 years and median OS was 3 years.
Conclusion:
Anti-PD-1 therapy was associated with a manageable safety profile in patients with recurrent meningiomas. Patients with WHO Grade III tumors and positive PD-1/PD-L1 expression were noted to have increased PFS and OS, suggesting a potential role for immunotherapy in these patients, but further studies are needed to investigate this in a larger patient population.
Insights
Immunotherapy with anti-PD-1 inhibitors shows promise for recurrent meningiomas, particularly for high-grade tumors. This treatment offers a manageable safety profile and improved progression-free survival (PFS) and overall survival (OS) in select patients.
Area of Science:
- Neuro-oncology
- Immunotherapy
- Meningioma Research
Background:
- Meningiomas progressing after surgery and radiotherapy present a significant clinical challenge.
- PD-1 and PD-L1 expression correlates with meningioma grade, indicating potential therapeutic targets.
- Investigating immunotherapy is crucial for managing recurrent meningiomas.
Purpose of the Study:
- To evaluate the efficacy and safety of anti-PD-1 inhibitor therapy in patients with recurrent meningiomas.
- To describe progression-free survival (PFS) and overall survival (OS) in this patient cohort.
- To identify potential predictive markers for treatment response.
Main Methods:
- Retrospective chart review of patients treated with PD-1 inhibitors at UPMC Hillman Cancer Center.
- Inclusion criteria: patients over 18 with meningioma receiving immunotherapy.
- Treatment continued until disease progression, toxicity, death, or physician decision; radiographic assessments every 3-6 months.
Main Results:
- Eight patients received anti-PD-1 therapy between January 2015 and November 2021.
- Median PFS was 7 months and median OS was 1.75 years.
- Patients with positive PD-1/PD-L1 expression showed improved outcomes: median PFS of 2 years and median OS of 3 years.
Conclusions:
- Anti-PD-1 therapy demonstrates a manageable safety profile in recurrent meningioma patients.
- WHO Grade III tumors and positive PD-1/PD-L1 expression are associated with enhanced PFS and OS.
- Further research with larger cohorts is warranted to confirm immunotherapy's role in meningioma treatment.
