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BioMed Research International
Volume 2015, Article ID 267831, 11 pages
http://dx.doi.org/10.1155/2015/267831
Review Article

The Role of Mifepristone in Meningiomas Management: A Systematic Review of the Literature

1Service of Neurosurgery, Department of Clinical Neuroscience, Faculty of Human Medicine and Biology, University Hospital of Lausanne, 46 rue du Bugnon, 1011 Lausanne, Switzerland
2Department of Neurosurgery, University Hospital of Bicetre, Faculty of Medicine of Paris Sud, 78 rue du Général Leclerc, 94270 Le Kremlin-Bicêtre, France

Received 26 February 2015; Accepted 27 April 2015

Academic Editor: Maria Caffo

Copyright © 2015 Giulia Cossu et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives. We performed a systematic literature review to analyze the clinical application and the safety of mifepristone, a prominent antiprogesterone agent, in meningioma patients. Materials and Methods. A systematic search was performed through Medline, Cochrane, and clinicaltrials.gov databases from 1960 to 2014. Study Selection. Studies were selected through a PICO approach. Population was meningioma patients, meningioma cells cultures, and animal models. Intervention was mifepristone administration. Control was placebo administration or any other drug tested. Outcomes were clinical and radiological responsiveness, safety profile, and cell growth inhibition. Results. A total of 7 preclinical and 6 clinical studies and one abstract were included. Encouraging results were found in preclinical studies. Concerning clinical studies, the response rate to mifepristone in terms of radiological regression and symptomatic improvement/stability in patients with inoperable meningioma was low. In meningiomatosis, favorable preliminary results were recorded. The safety profile was good. Limitations were as follows. The tumoral expression of progesterone receptors was not analyzed systematically in every study considered. Conclusions. No clear evidence exists to recommend mifepristone in inoperable meningiomas. Preliminary encouraging results were found in diffuse meningiomatosis. Mifepristone is a well-tolerated treatment. Patients’ selection and hormonal profile analysis in meningiomas are fundamental for a better understanding of its benefit. Multicenter placebo-controlled trials are required.