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. 2025 Sep 16;32(9):516.
doi: 10.3390/curroncol32090516.

A Retrospective Study on Prognostic Factors and Systemic Treatments of Refractory Meningiomas

Dan-Thanh Christine Nguyen  1 , Cyril Nader  2 , Karl Bélanger  1 , Sarah Lapointe  1 , Bernard Lemieux  1 , Émilie Lemieux-Blanchard  1 , Jean-Paul Bahary  3 , Laura Masucci  3 , Carole Lambert  3 , David Roberge  3 , Robert Moumdjian  4 , Moujahed Labidi  4 , Romain Cayrol  5 , Marie Florescu  1
Affiliations

A Retrospective Study on Prognostic Factors and Systemic Treatments of Refractory Meningiomas

Dan-Thanh Christine Nguyen et al. Curr Oncol. .

Abstract

Standard systemic treatment has not been established for refractory meningioma. This retrospective study aimed to identify prognostic factors for overall survival and document outcomes of systemic therapies. We reviewed patients with meningioma followed at CHUM hospital between 2006 and 2022. Only patients with progression after first-line treatment were included. Among 750 patients, 107 (14%) experienced progression after first-line treatment. They were divided into two groups: Group 1 (n = 69, 64%) received salvage local treatments, and Group 2 (n = 38, 36%) received additional salvage systemic treatments. The median follow-up time from diagnosis was 7.5 years. 10-year OS was 88.3% (Group 1) vs. 67.2% (Group 2) (p = 0.009). Mean survival after stopping systemic treatment was 8.94 months. Key prognostic factors for poorer survival included age ≥ 65 (HR = 2.82; p = 0.009), WHO grade 2 or 3 (HR = 4.25; p = 0.004), and progression after second-line treatment (HR = 4.77; p = 0.004). Bevacizumab was associated with a mPFS of 12 months and 1-year OS of 64,6%, whereas non-Bevacizumab treatments-including Hydroxyurea, Somatostatin, and Sunitinib-were associated with a mPFS of 7 months and 1-year OS of 52,6%. This study highlights the fatal nature of recurrent meningiomas and the urgent need for systemic treatments that can improve their survival.

Keywords: bevacizumab; meningioma; prognostic factor; systemic treatments.

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Conflict of interest statement

Sarah Lapointe is a consultant and has received honoraria from Bayer, Alexion, Novocure, and MD Analytics. Moujahed Labidi is a consultant for Alexion Pharmaceuticals. Carole Lambert is a consultant for Sumitomo Pharma and receives honoraria from Tolmar. Émilie Lemieux-Blanchard receives honoraria from Janssen, BMS, Sanofi, and Amgen. She also serves as a consultant for Apotex, Janssen, and Pfizer. David Roberge has received research funding from Varian Medical Systems, Siemens Healthineers, Elekta, Bristol-Myers Squibb, and IntraOp Medical. He is a consultant for Recordati Rare Diseases, Precirix, Novocure, and Servier, and receives honoraria from Pfizer/Merck Serono, BrainLAB, Siemens Healthineers, Roche Canada, Zap Surgical, Bayer, Accuray, Kyowa Kirin, and AstraZeneca Canada. He also holds equity in Croton Healthcare, Arctic Fox AI, and Miso Chip. Romain Cayrol is a co-inventor of VAL-CHUM. Bernard Lemieux is a consultant for Janssen. Marie Florescu has received honoraria for presentations and participation on advisory boards from AstraZeneca, Merck, Bristol Myers Squibb (BMS), Roche, Takeda, EMD Serono, Servier, Janssen, and Pfizer. She has also received research funding from Novartis, AstraZeneca, and BMS. Dan-Thanh Christine Nguyen, Cyril Nader, Jean-Paul Bahary, Robert Moumdjian, and Giuseppina Laura Masucci have no conflicts of interest.

Figures

Figure 1
Figure 1
Patient flow diagram illustrating the selection of patients.
Figure 2
Figure 2
Progression-free survival of Group 1 in comparison with Group 2 (a) On first-line therapy (PFS-1); (b) On second-line therapy (PFS-2).
Figure 3
Figure 3
History of patients with refractory meningioma under systemic treatments: (a) with a follow-up under 10 years; (b) with a follow-up over 10 years.
Figure 4
Figure 4
Outcomes of patients under systemic treatments including (a) progression-free survival and (b) overall survival curves based on systemic treatment received.
See this image and copyright information in PMC

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