Review Article

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

Table 1


StudyYear specimens/animalsPurposePopulationHistology/PR expressionInterventionOutcome and resultsConclusion

Olson et al. [22]19863Evaluation of hormonal stimulation and hormonal deprivationHuman meningioma cell culturesHistology ns
ER and PR positive
Exposition to 10−6–10−10 M mifepristone for 28 dMifepristone inhibits cell growth (18–36%) in all 3 specimens when compared to the control medium (Coulter counter)PRO

Blankenstein et al. [23]198930 cultures form 39 tissue specimensEvaluation of mifepristone as inhibitor of cell growthHuman meningioma cell cultures PR expression measured but ns in the text
Histology ns
Exposition to 10−6–10−10 M mifepristone for 8 dGrowth inhibition with mifepristone exposure (decrease in TLI, thymidine labeling index )PRO

Koper et al. [24]19906Effect of progesterone and mifepristone on the response to EGFHuman meningioma cell cultures
2 M
PR expression ns in 1 case
EGFR expression ns in 2 cases
3 d incubation with 10−6 M mifepristoneEGF-stimulated incorporation of thymidine was reduced with mifepristone exposurePRO

Schrell et al. [25]198923Evaluation of effects of progesterone/mifepristone on cell growthHuman meningioma cell culturesVarying degrees of PR expressionExposition to 10−6–10−10 M mifepristone for 6–12 dNo stimulating nor inhibitory effect was foundCON

Wilisch-Neumann et al. [26]20144 (plus 3 other cell lines NF2wt and NF2ko)Efficacy of different chemotherapies/target therapies on meningioma cells growthHuman meningioma cell lines: in vitro analysis2 benign and 2 malignant meningiomas; PR expression nsExposition to different mifepristone concentration, till 10−6 MMifepristone showed some efficacy in growth inhibition only at very high doses and only in one cell lineCON

Matsuda et al. [27]199413 meningioma cell cultures
51 nude mice, female athymic, divided into 3 groups
Antitumor effects of mifepristone and onapristone and relationship with PR expressionHuman meningioma tissue (13 specimens), previously untreated
Cell cultures and cells implanted in subrenal capsule of athymic mice
9 meningothelial
2 transitional
1 angiomatous
1 fibroblastic
4/13 PR +
3 tumors implanted
2 meningothelial PR+
1 angiomatous PR−
Exposition to 10−6–10−10 M of antiprogestogen in vitro, evaluated at 9 d and 21 d
Injection 0.4 mL of mifepristone, onapristone, or placebo for 28 d
Antitumor effects via PRs and/or another receptor
In vitro: cytostatic and cytocidal effects regardless of the presence of PRs (7/9 PR- responded)
In vivo: reduction of tumor volume regardless of the presence of PR (no necrosis)
PRO

Olson et al. [28]19876 nude mice, male athymic, divided into 2 groupsEffect of mifepristone on meningioma implanted into nude mice1 human meningioma implanted in the subcutaneous tissue of nude miceMeningothelial histology
PR expression
Mifepristone 10 mg/kg/d for 3 moDisappearance of implanted meningioma nodules in 2/3 mice in 8–10 w; a small number of cells in the third casePRO

CON: against; d: days; EGF: epithelial growth factor; ER: estrogen receptors; M: molar; ns: not specified; PR: progesterone receptors; PRO: for, in favor of; w: weeks.