001052252 001__ 1052252 001052252 005__ 20260122203308.0 001052252 0247_ $$2doi$$a10.1093/neuonc/noaf009 001052252 0247_ $$2ISSN$$a1522-8517 001052252 0247_ $$2ISSN$$a1523-5866 001052252 0247_ $$2datacite_doi$$a10.34734/FZJ-2026-00869 001052252 037__ $$aFZJ-2026-00869 001052252 082__ $$a610 001052252 1001_ $$0P:(DE-HGF)0$$aKotecha, Rupesh$$b0$$eCorresponding author 001052252 245__ $$aBenchmarking the efficacy of salvage systemic therapies for recurrent meningioma: A RANO group systematic review and meta-analysis to guide clinical trial design 001052252 260__ $$aOxford$$bOxford Univ. Press$$c2025 001052252 3367_ $$2DRIVER$$aarticle 001052252 3367_ $$2DataCite$$aOutput Types/Journal article 001052252 3367_ $$0PUB:(DE-HGF)16$$2PUB:(DE-HGF)$$aJournal Article$$bjournal$$mjournal$$s1769088395_20964 001052252 3367_ $$2BibTeX$$aARTICLE 001052252 3367_ $$2ORCID$$aJOURNAL_ARTICLE 001052252 3367_ $$00$$2EndNote$$aJournal Article 001052252 500__ $$aNeuro Oncol . 2025 Sep 8;27(7):1670-1685.Funding: none declared 001052252 520__ $$aBackground. 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. 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