Radiopharmaceutical Therapy with [ 177 Lu]Lu-DOTATATE in Refractory Meningiomas: Results from the French Multicenter MELUTE Cohort
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.
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BibTeX
@article{garabedian2026radiopharmaceutical,
title = {{Radiopharmaceutical Therapy with [ 177 Lu]Lu-DOTATATE in Refractory Meningiomas: Results from the French Multicenter MELUTE Cohort}},
author = {Nicolas Garabedian and Timothée Zaragori and Emeline Tabouret and Luc Taillandier and Catherine Ansquer and Edouard Samarut and Sarah Boughdad and Marc Sanson and Caroline Bund and Georges-Noël Lambert and Catherine Cheze Le Rest and Anthony Joncour and Jacques Darcourt and Marie Onno and Gauthier Delaby and Enora Vauléon and Inna Dygai-Cochet, and François Ghiringhelli and Emmanuel Deshayes and Julien Boetto and Agathe Edet-Sanson and Adrien Carle-Ortiz and Anthime Flaus and François Ducray and Thibault Fidani and Jean-Sébastien Guillamo and Tatiana Horowitz and Pierre Meneret and Elodie Vauléon and Elske Quak and Jeanne Riverain and Solene Querellou and Vincent Bourbonne and Ghoufrane Tlili and Aymeri Huchet and Lavinia Vija and Justine Attal and Gabriela Hossu and Laëtitia Imbert and Betty Salgues and Éric Guedj and Matthieu Peyre and Thomas Graillon and Caroline Boursier and Antoine Verger},
journal = {Journal of Nuclear Medicine},
year = {2026},
month = oct,
doi = {10.2967/jnumed.126.272735},
url = {https://hal.science/hal-05830001v1},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Radiopharmaceutical Therapy with [ 177 Lu]Lu-DOTATATE in Refractory Meningiomas: Results from the French Multicenter MELUTE Cohort
AU - Nicolas Garabedian
AU - Timothée Zaragori
AU - Emeline Tabouret
AU - Luc Taillandier
AU - Catherine Ansquer
AU - Edouard Samarut
AU - Sarah Boughdad
AU - Marc Sanson
AU - Caroline Bund
AU - Georges-Noël Lambert
AU - Catherine Cheze Le Rest
AU - Anthony Joncour
AU - Jacques Darcourt
AU - Marie Onno
AU - Gauthier Delaby
AU - Enora Vauléon
AU - Inna Dygai-Cochet,
AU - François Ghiringhelli
AU - Emmanuel Deshayes
AU - Julien Boetto
AU - Agathe Edet-Sanson
AU - Adrien Carle-Ortiz
AU - Anthime Flaus
AU - François Ducray
AU - Thibault Fidani
AU - Jean-Sébastien Guillamo
AU - Tatiana Horowitz
AU - Pierre Meneret
AU - Elodie Vauléon
AU - Elske Quak
AU - Jeanne Riverain
AU - Solene Querellou
AU - Vincent Bourbonne
AU - Ghoufrane Tlili
AU - Aymeri Huchet
AU - Lavinia Vija
AU - Justine Attal
AU - Gabriela Hossu
AU - Laëtitia Imbert
AU - Betty Salgues
AU - Éric Guedj
AU - Matthieu Peyre
AU - Thomas Graillon
AU - Caroline Boursier
AU - Antoine Verger
PY - 2026
DA - 2026/10/21
JO - Journal of Nuclear Medicine
DO - 10.2967/jnumed.126.272735
UR - https://hal.science/hal-05830001v1
AB - 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.
SN - 0161-5505
SN - 1535-5667
ER -