Radiopharmaceutical Therapy with [¹⁷⁷Lu]Lu-DOTATATE in Refractory Meningiomas: Results from the French Multicenter MELUTE Cohort.

Authors

Nicolas Garabedian, Timothée Zaragori, Emeline Tabouret, Luc Taillandier, Catherine Ansquer, Edouard Samarut, Sarah Boughdad, Marc Sanson, Caroline Bund, Georges Noël, Catherine Cheze-Le-Rest, Anthony Joncour, Jacques Darcourt, Marie Onno, Gauthier Delaby, Enora Vauleon, Inna Dygai-Cochet, François Ghiringhelli, Emmanuel Deshayes, Julien Boetto, Agathe Edet-Sanson, Adrien Carle-Ortiz, Anthime Flaus, François Ducray, Thibault Fidani, Jean-Sébastien Guillamo, Tatiana Horowitz, Pierre Meneret, Elodie Vauleon, Elske Quak, Jeanne Riverain, Solène Querellou, Vincent Bourbonne, Ghoufrane Tlili, Aymeri Huchet, Lavinia Vija, Justine Attal, Gabriela Hossu, Laetitia Imbert, Betty Salgues, Eric Guedj, Matthieu Peyre, Thomas Graillon, Caroline Boursier, Antoine Verger

Published in

Journal of nuclear medicine : official publication, Society of Nuclear Medicine. Oct 15, 2026. Epub Oct 15, 2026.

Abstract

Evidence supporting the efficacy and safety of [¹⁷⁷Lu]Lu-DOTATATE in refractory meningiomas derives mainly from small, single-center studies. The French national multicenter MELUTE study aimed to consolidate these data using a standardized regimen within a compassionate-use program approved by a national multidisciplinary tumor board. Methods: In this retrospective multicenter cohort study, patients with refractory meningiomas treated with [¹⁷⁷Lu]Lu-DOTATATE in 18 French centers between July 2022 and December 2024 were included. Treatment consisted of 7.4 GBq every 8 wk for up to 4 cycles. Clinical data (demographics, histologic World Health Organization grade [WHO], prior treatments, number of cycles, toxicity, progression, survival status as of October 1, 2025) were collected. Baseline [⁶⁸Ga]Ga-DOTATOC PET and brain MRI scans obtained before and after treatment were centrally reviewed. The primary endpoint was 6-mo progression-free survival (PFS) assessed using volumetric Response Assessment in Neuro-Oncology Group criteria. Secondary endpoints were PFS, overall survival (OS), and safety. Results: Sixty-nine patients were included (mean age, 65.1 ± 13.2 y; 52% female): 13 WHO grade 1, 42 WHO grade 2, 8 WHO grade 3, and 6 without histology. Most had prior surgery (86%) or radiotherapy (93%); 32% received prior systemic therapy. Twelve patients (17%) did not complete 4 cycles; only one discontinuation was toxicity-related. Six-month PFS was 70% (95% CI, 58.7-80.4%). Median PFS was 14.6 mo (95% CI, 13.3-18.5 mo), and median OS was 27.6 mo (95% CI, 24.2 mo to not reached). Grade 3 adverse events, mainly lymphopenia, occurred in 16%. Meningioma WHO grade independently predicted PFS, whereas higher Karnofsky performance status and corticosteroid use were protective; worse OS was associated with higher baseline tumor growth rate and prior systemic therapy. Conclusion: MELUTE demonstrates promising efficacy and favorable safety of [¹⁷⁷Lu]Lu-DOTATATE in refractory meningiomas with limited therapeutic options.

PMID:
42880958
Bibliographic data and abstract were imported from PubMed on 16 Oct 2026.

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