Table 2

StudyYear ptsPurposePopulationHistology/PR expressionInterventionOutcome and resultsSide effectsLimitationsConclusion

Grunberg et al. [29]199114Efficacy of long-term oral therapy with mifepristone in unresectable meningiomas
11 pts were progressing (radiologically or symptomatically) before starting the TT with mifepristone
Inoperable meningiomas
6 M
8 F:
(i) 2 premenop 
(ii) 6 postmenop
5 meningothelial 3 cellular
2 fibrous meningioma
2 malignant meningioma
2 w/o biopsy
No evaluation of PR expression
Mifepristone 200 mg/d for 2–31 mo
(9 pts more than 12 mo)
Dexa 1 mg daily during the first 14 d of treatment
13 pts assessed for response
(1 refused)
(i) 5/13 pts radiological regression after at least 6 mo
(ii) 3/13 subjective clinical improvement after 2-3 mo
(iii) 3/13 progression (of which 2 were malignant meningiomas)
14 evaluated
(i) 11/14 fatigue
(ii) 5/14 hot flashes
(iii) 3/6 M gynecomastia
(iv) 2 alopecia
(v) 2 amenorrhea (premenop F)
(vi) 1 hypothyroidism
Subjective clinical evaluation
Radiological response evaluated with CT or MRI
Heterogenous population:
(i) 2 premenop F
(ii) 6 postmenop F
(iii) 6 men
No evaluation of PR expression
1 previous RT
4 previous hormonal therapy (MPA and tamoxifen)
For the 3 pts defined as stable before starting mifepristone, the previous FU is ns
PRO

Grunberg et al. [30]200628 (Included the 14 pts of the study of Grunberg et al. 1991 [29])Clinical tolerance of long-term treatment with mifepristone9 M
19 F:
(i) 5 premenop
(ii) 14 postmenop
13 meningothelial
4 fibroblastic
5 cellular/ns
2 malignant
4 not biopsied
No evaluation of PR expression
Mifepristone 200 mg/d for 2–31 mo
Mean FU 35 mo (2–157 mo)
Total of 1626 patient-months
Dexa 1 mg daily during the first 14 d of treatment
8/28 pts radiological (5) and clinical (3) improvement
(7/8 were male or premenopausal F)
22/28 pts mild fatigue
13/28 pts hot flashes
6/28 pts gynecomastia
3/28 depression
1 N/V
3/28 pts endometrial hyperplasia
1 pt peritoneal adenocarcinoma
2 malignant meningiomas
4 no histological diagnosis
No evaluation of PR expression
CON

Lamberts et al. [31]199210Effect of mifepristone treatment in recurrent or inoperable meningiomas
recent evidence of growing:
neuroradiological in 9 cases
ophthalmological in 4 cases
12 recurrent or inoperable meningiomas in 10 pts
7 pts previous operation
3 males
1 premenop F (with NF2)
6 postmenop F
No data about histology nor PR expressionMifepristone 200 mg/d for 12 mo
4 cases started Dexa 7.5 mg daily and continued throughout the study
5/12 meningiomas grew (2 deaths)
3/12 stable
4/12 transient regression (progression at discontinuation of TT)
5/10 pts symptomatic improvement
objective assessment in 2 pts
1 pt continued to deteriorate
Asthenia, N/VCT scan evaluation (planimetry)
Group of aggressive meningiomas (recent evidence of growing)
No data about histology nor PR expression
Graphic over responsive patients
Analyzable in different ways
PRO

De Keizer and Smit [32]20042Efficacy of long-term mifepristone treatmentUnresectable sphenoid-ridge meningioma
2 F: 1 postmenop F
Both tumors were PR +Mifepristone 200 mg/d then increased to 400 mg/d
Dexa 0.5 mg three times daily
FU 14 y
2 controlled tumor growth
1 improved VA
1 improved headache, stable VA
clinical deterioration, and radiological growth after TT discontinuation
Initial benefits persist
1 endometrial hyperplasiaCT and MRI evaluationPRO

Touat et al. [33]20143Efficacy of mifepristone in meningiomatosis F, postmenopHistological examination in one caseMifepristone 200 mg/d.
FU 4–10 y
3/3 long lasting clinical and 2/3 radiological response or stabilization1 benign ovarian serous cystadenomaSmall pts
Histological examination just in one case
PRO

Spitz et al. [34]200525To determine clinical side effects and biochemical abnormalities with long-term mifepristone therapy16 F and 9 M
22–80 y
unresectable meningioma
Mifepristone 200 mg/d (follow-up variable from 13 y to 4 mo)
Total of 1620 mo
Safety of long-term TT(i) 22/25 pts fatigue
(ii) 2 endometrial hyperplasia
(iii) 2 endometrial thickening
Varied follow-up
Heterogeneous cohort: 5 premenopausal F, 11 postmenopausal F, and 9 M
PRO

Grunberg et al. [35]2001160 (80 per arm)Efficacy of mifepristone in unresectable meningiomasAdults with unresectable histologically confirmed nonmalignant meningiomas appeared (22%) or progressing (78%) within 2 y
Median age 57 y
30% M
19% premenop F
51% postmenop F
29% prior RTH
nsBlinded administration of mifepristone 200 mg/d versus placebo
Follow-up 2 y
FFP (freedom from progression)
Progression defined as anatomic growth or neurologic deterioration
No significant difference in response between the arms: median FFP was 10 mo for mifepristone pts and 12 mo for placebo pts ()
Fatigue (72% mifepristone pts vs 54% placebo pts)
Headache
Hot flashes
9 mifepristone pts had endometrial hyperplasia (16% F)
Limited data available (abstract)
No information about histological type and PR expression
CON

CON: against; d: days; dexa: dexamethasone; EGF: epithelial growth factor; ER: estrogen receptors; F: female; M: male; mo: months; : number; ns: not specified; N/V: nausea and vomiting; PR: progesterone receptors; Postmenop: postmenopausal; Premenop: premenopausal; PRO: for, in favor of; Pts: patients; TT: treatment; VA: visual acuity; y: years; w: weeks; w/o: without.