543P - Bevacizumab and hydroxyurea treatment in grade 2 and 3 meningioma: A monocentric experience

Background

Various systemic treatments for recurrent meningiomas (MEN) have been investigated with controversial results. We analyzed and compared the role of bevacizumab (BEV) and hydroxyurea (HYD).

Methods

Retrospectively, we analyzed recurrent grade 2 and 3 MEN PTS receiving BEV or HYD at the Veneto Institute of Oncology (Padua, Italy) from Nov 2011 to March 2023. All pts were not more amenable for surgery or RT. NGS data (Foundation One) were also collected. Kaplan-Meier curves were for survival rate; RANO criteria were used for radiological assessment.

Results

31 pts in the BEV cohort were included. Baseline data for the BEV cohort were: 13 (41.9%) female pts; 17 (54.8%) below 65 years old; 16 (51.6%) PS ECOG <2; ≤2 previous surgeries in 17 (54%); 28 (90.3%) with less than 2 previous treatments. BEV was administered at 5 or 10 mg/Kg q2w or 7.5 mg/Kg q3w schedule. 13 pts were included in the HYD cohort. Baseline data for the HYD cohort were: 9 (69%) female pts; 5 (38%) < 65 years old; 6 (46%) ECOG PS <2; ≤2 previous surgeries in 8 (61%); 1 (8%) previously treated. HYD was administered at 1000 mg/day. Pts affected by NF2 were 1 (8%) in HYD cohort and 2 (6%) in the BEV cohort. Pts treated with BEV achieved a DCR of 86.7%; mPFS was 19.6ms [95%CI: 10.6-NA]; 6m-PFS rate was 84.6% [95% CI 71.6-99.8]; mOS was 16.1ms [95%CI: 11.4-NA]; median follow up was 17.5ms. Pts treated with HYD achieved a DCR of 53.8 %; mPFS 5.6ms [95%CI: 2.9-NA]; 6m PFS 49.4% [95% CI 27.4-88.9]; mOS 22.6ms [95%CI: 12.3-NA]; median follow up was 117,1ms. Difference in OS was not statistically significant (p-value 0.8256), but difference in PFS was statistically significant (p-value 0.0026). NGS data were available for 22 pts (71%) of the BEV cohort; NF2 mutations were detected in 14 (63.63%); PTEN loss/mutation in 3 (9.67%); FGFR, JAK, ALK each in 1 case (3.2%).

Conclusions

BEV can be considered a useful therapeutic option to control disease in recurrent MEN pts although it appears not to impact survival compared to HYD. Further analyses on predictive biomarkers of efficacy is needed.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

IRCCS Istituto Oncologico Veneto.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.