Somatostatin receptor (SSTR)-targeted
peptide receptor radionuclide therapy (PRRT) represents a promising approach for treatment-refractory
meningiomas progressing after surgery and
radiotherapy. The aim of this study was to provide outcomes of patients harboring refractory
meningiomas treated by
177Lu-DOTATATE and an overall analysis of progression-free survival at 6 months (PFS-6) of the same relevant studies in the literature. Eight patients with recurrent and progressive WHO grade II
meningiomas were treated after multimodal pretreatment with
177Lu-DOTATATE between 2019 and 2022. Primary and secondarily endpoints were progression-free survival at 6-months (PFS-6) and toxicity, respectively. PFS-6 analysis of our case series was compared with other similar relevant studies that included 86 patients treated with either
177Lu-DOTATATE or
90Y-DOTATOC. Our retrospective study showed a PFS-6 of 85.7% for WHO grade II progressive refractory
meningiomas. Treatment was clinically and biologically well tolerated. The overall analysis of the previous relevant studies showed a PFS-6 of 89.7% for WHO grade I
meningiomas (n = 29); 57.1% for WHO grade II (n = 21); and 0 % for WHO grade III (n = 12). For all grades (n = 86), including unknown grades, PFS-6 was 58.1%. SSTR-targeted PRRT allowed us to achieve prolonged PFS-6 in patients with WHO grade I and II progressive refractory
meningiomas, except the most aggressive WHO grade II
tumors. Large scale randomized trials are warranted for the better integration of PRRT in the treatment of refractory
meningioma into clinical practice guidelines.