%0 Journal Article
%A Kotecha, Rupesh
%A Akdemir, Eyub Y
%A Kutuk, Tugce
%A Ilgın, Can
%A Ahluwalia, Manmeet S
%A Bi, Wenya L
%A Blakeley, Jaishri
%A Dixit, Karan S
%A Dunn, Ian F
%A Galanis, Evanthia
%A Galldiks, Norbert
%A Huang, Raymond Y
%A Johnson, Derek R
%A Kaley, Thomas J
%A Kamson, David O
%A Kurz, Sylvia C
%A McDermott, Michael W
%A Odia, Yazmin
%A Preusser, Matthias
%A Raizer, Jeffrey
%A Reardon, David A
%A Rogers, C Leland
%A Ruda, Roberta
%A Schiff, David
%A Vogelbaum, Michael A
%A Weller, Michael
%A Wen, Patrick Y
%A Mehta, Minesh P
%T Benchmarking the efficacy of salvage systemic therapies for recurrent meningioma: A RANO group systematic review and meta-analysis to guide clinical trial design
%J Neuro-Oncology
%V 27
%N 7
%@ 1522-8517
%C Oxford
%I Oxford Univ. Press
%M FZJ-2026-00869
%P 1670 - 1685
%D 2025
%Z Neuro Oncol . 2025 Sep 8;27(7):1670-1685.Funding: none declared
%X Background. Despite advances in our understanding of the molecular underpinnings of meningioma progressionand innovations in systemic and local treatments, recurrent meningiomas remain a substantial therapeutic challenge.The objective of this systematic review and meta-analysis is to provide a historical baseline, contemporaryanalysis, and propose a “rate of probable interest” to inform future clinical trial design and development on behalfof the Response Assessment in Neuro-Oncology meningioma group.Methods. PubMed, ClinicalTrials.gov, and ASCOpubs databases were screened for clinical trials evaluating theactivity of systemic therapies for adults with recurrent meningiomas. The pooled progression-free survival at6-months and 1-year (PFS-6 and PFS-1 year) values were calculated using the random effects technique withI2 indices.Results. The pooled PFS-6 and PFS-1 year rates for recurrent WHO grade 1 meningiomas were 43.6% (95% CI:22.7-67.0%, I2 = 80%) and 21.7% (95% CI: 6.2-53.9%, I2 = 76%), and for grades 2-3 meningiomas, the PFS-6 was 38.0%(95% CI: 28.3-48.8%, I2 = 68%). In the targeted therapy group, PFS-6 and PFS-1 year rates stood at 62.0% (I2 = 58%)and 49.0% (I2 = 63%) for grade 1, while for grades 2-3 tumors, the PFS-6 rates with targeted therapy and immunotherapywere 42.1% (I² = 60%) and 46.0% (I² = 0%), respectively. The benchmarks were set at 67% and 54% for PFS-6and PFS-1 year for grade 1 tumors, and PFS-6 of 49% for grades 2-3 tumors.Conclusions. Several studies have reported outcomes in patients with recurrent meningiomas testing a variety ofagents with modest, but variable and progressively increasing activity. In this context, we recommend new benchmarksfor future trials to define efficacy of future investigational therapies.
%F PUB:(DE-HGF)16
%9 Journal Article
%R 10.1093/neuonc/noaf009
%U https://juser.fz-juelich.de/record/1052252