Sunitinib appeared effective in patients with recurrent atypical and malignant meningioma, according to results of a prospective, multicenter, phase 2 trial.
Because no effective treatment for patients with surgery- and radiation-refractory meningiomas, the findings suggest a randomized trial should be performed to evaluate sunitinib in this setting, researchers wrote.
Sunitinib (Sutent, Pfizer) — a small-molecule tyrosine kinase inhibitor — targets the vascular endothelial growth factor receptor (VEGFR) and platelet-derived growth factor receptor, both of which are prevalent in meningiomas.
Thomas J. Kaley, MD, of the department of neurology at Memorial Sloan Kettering Cancer Center, and colleagues enrolled 36 patients with surgery- and radiation-refractory recurrent meningioma. All patients had WHO grade 2 to grade 3 disease.
In an additional exploratory cohort, researchers enrolled 13 patients with WHO grade 1 meningioma, hemangiopericytoma or hemangioblastoma.
Patients received 50 mg daily sunitinib on days 1 to 28 of every 42-day cycle. PFS at 6 months served as the primary outcome measure. Secondary outcomes included radiographic response rate, safety, PFS and OS.
Patients had a median of five recurrences. The 6-month PFS rate was 42%, median PFS was 5.2 months (95% CI, 2.8-8.3) and median OS was 24.6 months (95% CI, 16.5-38.4).
Researchers reported significantly longer median PFS among patients who were VEGFR2-positive compared with VEGFR2-negative (6.4 months vs. 1.4 months; P=.005).
One patient developed grade 5 intratumoral hemorrhage. Researchers reported three central nervous system/intratumoral hemorrhages (grade 3, n=2; grade 4, n=1); two incidents of thrombotic microangiopathy (grade 3, n=1; grade 4, n=1); and one incident of grade 3 gastrointestinal perforation.
Disclosure: See the study for a full list of the researchers’ relevant financial disclosures.