{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T03:50:13Z","timestamp":1792813813011,"version":"4.5.0"},"reference-count":51,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2025,1,14]],"date-time":"2025-01-14T00:00:00Z","timestamp":1736812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite advances in our understanding of the molecular underpinnings of meningioma progression and innovations in systemic and local treatments, recurrent meningiomas remain a substantial therapeutic challenge. The objective of this systematic review and meta-analysis is to provide a historical baseline, contemporary analysis, and propose a \u201crate of probable interest\u201d to inform future clinical trial design and development on behalf of the Response Assessment in Neuro-Oncology meningioma group.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, ClinicalTrials.gov, and ASCOpubs databases were screened for clinical trials evaluating the activity of systemic therapies for adults with recurrent meningiomas. The pooled progression-free survival at 6-months and 1-year (PFS-6 and PFS-1 year) values were calculated using the random effects technique with I2 indices.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The pooled PFS-6 and PFS-1 year rates for recurrent WHO grade 1 meningiomas were 43.6% (95% CI: 22.7-67.0%, I2 = 80%) and 21.7% (95% CI: 6.2-53.9%, I2 = 76%), and for grades 2-3 meningiomas, the PFS-6 was 38.0% (95% CI: 28.3-48.8%, I2 = 68%). In the targeted therapy group, PFS-6 and PFS-1 year rates stood at 62.0% (I2 = 58%) and 49.0% (I2 = 63%) for grade 1, while for grades 2-3 tumors, the PFS-6 rates with targeted therapy and immunotherapy were 42.1% (I\u00b2 = 60%) and 46.0% (I\u00b2 = 0%), respectively. The benchmarks were set at 67% and 54% for PFS-6 and PFS-1 year for grade 1 tumors, and PFS-6 of 49% for grades 2-3 tumors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Several studies have reported outcomes in patients with recurrent meningiomas testing a variety of agents with modest, but variable and progressively increasing activity. In this context, we recommend new benchmarks for future trials to define efficacy of future investigational therapies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/neuonc\/noaf009","type":"journal-article","created":{"date-parts":[[2025,1,10]],"date-time":"2025-01-10T15:26:58Z","timestamp":1736522818000},"page":"1670-1685","source":"Crossref","is-referenced-by-count":29,"title":["Benchmarking the efficacy of salvage systemic therapies for recurrent meningioma: A RANO group systematic review and meta-analysis to guide clinical trial design"],"prefix":"10.1093","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6927-0402","authenticated-orcid":false,"given":"Rupesh","family":"Kotecha","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida , Miami, Florida ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6848-4289","authenticated-orcid":false,"given":"Eyub Y","family":"Akdemir","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Ko\u00e7 University School of Medicine , Istanbul ,","place":["Turkey"]},{"name":"Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida , Miami, Florida ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tugce","family":"Kutuk","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Miami Cancer Institute, Baptist Health South Florida , Miami, Florida ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Can","family":"Ilg\u0131n","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Institute of Oncology, University of Istanbul , Istanbul ,","place":["Turkey"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manmeet S","family":"Ahluwalia","sequence":"additional","affiliation":[{"name":"Department of Medical Oncology, Miami Cancer Institute, Baptist Health South Florida , Miami, Florida ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenya L","family":"Bi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women\u2019s Hospital, Harvard Medical School , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1049-0993","authenticated-orcid":false,"given":"Jaishri","family":"Blakeley","sequence":"additional","affiliation":[{"name":"Department of Neurology, Johns Hopkins University School of Medicine , Baltimore, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karan S","family":"Dixit","sequence":"additional","affiliation":[{"name":"Division of Neuro-Oncology, Department of Neurology, Feinberg School of Medicine Northwestern University , Chicago, Illinois ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian F","family":"Dunn","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, University of Oklahoma Health Sciences Center , Oklahoma City, Oklahoma ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8014-786X","authenticated-orcid":false,"given":"Evanthia","family":"Galanis","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Mayo Clinic , Rochester, Minnesota ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2485-1796","authenticated-orcid":false,"given":"Norbert","family":"Galldiks","sequence":"additional","affiliation":[{"name":"Research Center Juelich, Institute of Neuroscience and Medicine , Juelich ,","place":["Germany"]},{"name":"Department of Neurology, Faculty of Medicine, University of Cologne and University Hospital Cologne , Cologne ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond Y","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Radiology, Brigham and Women\u2019s Hospital, Harvard Medical School , Boston, Massachusetts ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Derek R","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Radiology, Mayo Clinic, Rochester, Minnesota, USA; Department of Neurology, Mayo Clinic , Rochester, Minnesota ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas J","family":"Kaley","sequence":"additional","affiliation":[{"name":"Department of Neurology, Memorial Sloan Kettering Cancer Center , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David O","family":"Kamson","sequence":"additional","affiliation":[{"name":"Sidney Kimmel Comprehensive Cancer Center, The Johns Hopkins University School of Medicine , Baltimore, Maryland ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sylvia C","family":"Kurz","sequence":"additional","affiliation":[{"name":"Department of Neuro-Oncology, Yale University School of Medicine , New Haven, Connecticut ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael W","family":"McDermott","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Miami Neuroscience Institute , Baptist 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