Cancer Treatment Today » Other (not glial) Cancers

What is available for metastatic and aggressive meningioma

M Levin, MD — Wed, 19 Dec 2012 15:26:52 +0000

Most meningiomas are slow and benign, but a small subset can be aggressive and ahs agressive pathological features. In a 2008 review of the aggressive types, atypical and anaplastic-meningiomas, the mean overall survival for atypical meningiomas was found to be 11.9 years vs. 3.3 years for anaplastic meningiomas. Meningiomas often depend and blood vessels and and it is reasonable to consider anti blood vessel therapy for meningioma. In particular, malignant meningiomas produce high levels of vascular endothelial growth factor (VEGF) and it would make sense that Avastin should be effective, because it blocks this factor. However, agressive and anaplastic meningiomas are rare and there is little known about what works and what does not work for it. Temodar appears ineffective for refractory meningioma, but hydroxyurea is more promising.

Angiogenesis inhibitors, progestins, agents that target fundamental cell signaling pathways, somatostatin analogues, and a variety of other molecular treatments are being investigated.

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Allogeneic stem cell transplantation for medulloblastoma

M Levin, MD — Fri, 24 Aug 2012 17:33:28 +0000

Medulloblastoma is a brain cancer that is treated primarily with surgical excision followed by radiation therapy and chemotherapy. When there is spinal extension, craniospinal(brain and spine) radiation is standard.

Inoperable medulloblastomas are often treated with chemotherapy but there is no randomized prospective evidence to support this. This is especially so in adults, in whom this disease is less common than in children and in whom it appears to behave distinctly differently. 30% of medulloblastoma cases occur in adults.

Autologous transplantation of relapsed disease has support from case reports, case series and small prospective trials. What to do if the disease returns after an autologous transplant? We don’t know. There are but a few case reports of allogeneic transplantation for medulloblastoma, some of them from the older literature. I am not aware of any cases of allogeneic stem cell being used after failure of autologous stem cell transplantation that have been reported.

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