Ivemos and octreotides to treat recurrent meningiomas

Backgroundgrowth inhibitor type 2 receptor expression enhancement and Pi3K/Akt/mTOR pathway activationIn in vitro experiments, the combination of mTOR inhibitor sylvemer and growth inhibitor octreotide showed better anti-tumor effectThomas Graillon of neurosurgery at the University of Marseille in France, among others, conducted the CEVOREM II trial to analyze the efficacy of the combination of ivemos and octreotide synods for recurrent meningiomas, published in the February 2020 journal Clinical Clinical Researchresearch methodology
CEVOREM is an open label, forward-looking, multi-center, single-arm PHASE II trial conducted at two medical centres in FranceThe subjects were included in the criteria: age of 18 years, Karnofsky functional status score of 50%, histological confirmation that meningioma was graded WHO-I, II or III and was not suitable for surgery or radiation therapy, and confirmed the occurrence of tumors based on two MRI examinationsProgress, i.e2D tumor area increased by 3 months to 5% or 6 months to 10%, tumor two-dimensional area of the maximum diameter of the tumor on the same layer multiplied by the maximum vertical diameter of the product, life expectancy of 3 months, blood system, kidney and liver function is goodThe patient took the dose, oquatin on the first day 30 mg/d and eviemost s1-28 day 10mg/dThe oral fixed dose of Evimos is 10 mg/d, which can be reduced by 5 mg in the event of adverse reactions (AE)Oquatin is injected with 30 mg of muscle per month until the tumor progressesAssess tumor progression according to the Neurotumor Response Assessment criteriaClinical assessments are conducted once a monthImaging assessment, MRI examination when included in the study, and every 3 months thereafter, until the tumor progressesThe main endpoint indicator is the 6-month progression-free survival rate (PFS6)The secondary endpoint indicators are total survival rate, response rate, tumor growth rate and safety study results included a total of 20 patients, including 8 male sons and 12 females, aged 30-75 and median age 35 The median follow-up time is 21 months The results showed that of the 20 patients, 2 were WHO Class I meningiomas, 10 were WHO Class II meningengocical sympaths, 8 were WHO CLASS III meningiomas, and 4 had NF2 reproductive gene mutations Overall PFS6 was 55% (95% CI, 31.3%-73.5%), and 6- and 12-month survival rates were 90% (95% CI, 65.6%-97.4%) and 75% (95% CI, 50.0%-88.7%) At 3 months of treatment, 78% of tumor volume growth decreased significantly, i.e by 50% The growth rate of the median tumor decreased from 16.6% three months ago to 0.02%/3 months (P 0.0002) at 3 months and 0.48%/3 months (P 0.0003) at 6 months of treatment Of the 20 patients, 11 (55%) developed oral inflammation, of which 3 were Grade III adverse complications, 1 required discontinuation of two drugs and 1 discontinued only evisimus conclusions
the study suggests that the combination of evimosand and octreotide has a better anti-meningioma activity effect In addition, tumor growth rate can be used as a reliable basis for analyzing the therapeutic effect of meningioma, and can be used to evaluate the results of clinical trials of meningioma.