University of California San Francisco
UCSF School of Medicine UCSF Medical Center

Low-Risk Meningioma: Initial Outcomes from NRG Oncology/RTOG 0539.

Neuro-oncology
2022
https://researcherprofiles.org/profile/299073936
35657335
Rogers CL, Pugh SL, Vogelbaum MA, Perry A, Ashby LS, Modi JM, Alleman AM, Barani IJ, Braunstein S, Bovi JA, de Groot JF, Whitton AC, Lindhorst SM, Deb N, Shrieve DC, Shu HK, Bloom B, Machtay M, Mishra MV, Robinson CG, Won M, Mehta MP
Abstract

BACKGROUND

Three- and five-year progression-free survival (PFS) for low-risk meningioma managed with surgery and observation exceeds 90%. Herewith we summarize outcomes for low-risk meningioma patients enrolled on NRG/RTOG 0539.

METHODS

This phase II trial allocated patients to 1 of 3 groups per WHO grade, recurrence status, and resection extent. Low-risk patients had either gross total (GTR) or subtotal resection (STR) for a newly diagnosed grade 1 meningioma and were observed after surgery. The primary endpoint was 3-year PFS. Adverse events (AEs) were scored using CTCAE version 3.

RESULTS

Among 60 evaluable patients, median follow-up was 9.1 years. The 3, 5, and 10 year rates were 91.4% (95% CI:84.2-98.6), 89.4% (95% CI:81.3-97.5), 85.0% (95% CI:75.3-94.7) for PFS and 98.3% (95% CI:94.9-100), 98.3%, (95% CI:94.9-100), 93.8% (95% CI:87.0-100) for overall survival (OS), respectively. With centrally confirmed GTR, 3/5/10y PFS and OS rates were 94.3/94.3/87.6% and 97.1/97.1/90.4%. With STR, 3/5/10y PFS rates were 83.1/72.7/72.7% and 10y OS 100%. Five patients reported 1 grade 3, 4 grade 2, and 5 grade 1 adverse events. There were no grade 4 or 5 adverse events.

CONCLUSIONS

These results prospectively validate high PFS and OS for low-risk meningioma managed surgically but raise questions regarding optimal management following STR, a subcohort that could potentially benefit from adjuvant therapy.