refractory recurrent atypical and malignant meningiomas
Conditions
Interventions
PD-L1 inhibitor group:PD-L1 inhibitor 1200mg ivgtt Q3W
EVE+PD-L1 inhitor group:Everolimus 10mg PO QD+PD-L1 inhibitor 1200mg ivgtt Q3W
Sponsors
Department of neurosurgery, Beijing Tiantan Hospital, Capital Medical University
Eligibility
Sex/Gender
All
Age
18 Years to 80 Years
Inclusion criteria
Inclusion criteria: 1. Both sexual, be willing and able to provide written informed consent/assent for the trial. Be >/= 18 years of age on day of signing informed consent, 5 to 18 years of age signing informed consent by parents; 2. Have histologically confirmed World Health Organization Grade II or III meningiomas (atypical or anaplasia meningiomas). Participants will be eligible if the original histology was low-grade meningioma and a subsequent histological diagnosis of atypical or anaplasia meningiomas is made; 3. Patients must be at first or second relapse and clinically require reoperation for tumor progression within 4 to 6 weeks. Note: Relapse is defined as progression following initial therapy (i.e., radiation). If the participant had a surgical resection for relapsed disease and no antitumor therapy instituted for up to 12 weeks, this is considered one relapse; 4. Have provided tissue from an archival tissue sample or newly obtained core or excisional biopsy of a tumor lesion; 5. Molecular diagnosis of tumor tissue: the mutation of PIK3CA gene, KRAS gene mutation, TSC1 gene mutation, PTEN expression decreased, meet the above 2 and above. High expression of PD-L1 in tumor tissue, and tumor infiltrating lymphocytes consider as drug specifically targeting T-cell co-stimulation or checkpoint pathways; 6. Have a performance status of >/= 60 on the Karnofsky Performance Scale (KPS); 7. Stable dose of steroids for 5 days, no more than 2 mg dexamethasone (or equivalent) total per day; 8. Demonstrate adequate organ function as defined in additional table 1, all screening labs should be performed within 14 days prior to registration: 1) Hematological: Absolute neutrophil count (ANC) >/=1,500 /mcL; Platelets >/=100,000/mcL; Hemoglobin >/= 9 g/dL or >/= 5.6 mmol/L; 2) Renal: Serum creatinine /= 60 mL/min for subject with creatinine levels > 1.5 * institutional ULN; 3) Coagulation: International Normalized Ratio (INR) or Prothrombin Time (PT) 1.5 ULN; AST (SGOT) and ALT (SGPT)
Exclusion criteria
Exclusion criteria: 1. Has been treated previously with bevacizumab; 2. Has tumor localized primarily to the brainstem or spinal cord; 3. Has received prior interstitial brachytherapy, implanted chemotherapy, or therapeutics delivered by local injection or convection enhanced delivery; 4. Is currently participating in or has participated in a study of an investigational agent or using an investigational device 4 weeks since last dose of agent administration; 5. Has a diagnosis of immunodeficiency or is receiving systemic steroid therapy > 2 mg of dexamethasone total per day or any other form of immunosuppressive therapy within 7 days prior to the first dose of trial; 6. Has evidence of interstitial lung disease or active, non-infectious pneumonitis; 7. Has an active infection requiring systemic therapy; 8. Is pregnant or breastfeeding, or expecting to conceive or father children within the projected duration of the trial, starting with the screening visit through 120 days after the last dose of trial treatment; 9. Has received prior therapy with an anti-PD-1, anti-PD-L1, anti-PD-L2, anti-CD137 antibody (including ipilimumab or any other antibody or drug specifically targeting T-cell co-stimulation or checkpoint pathways); 10. Has a known history of Human Immunodeficiency Virus (HIV) (HIV 1/2 antibodies). Testing not required. Has known history of Hepatitis B (e.g., HBsAg reactive) or Hepatitis C (e.g., HCV RNA [qualitative] is detected). Testing not required; 11. Has received a live vaccine within 30 days prior to the first dose of trial treatment.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Tumor size;Mortality in 2 years;progression free survival;overall survival; | — |
Countries
China
Contacts
Public ContactZhang Guobin
Department of neurosurgery, Beijing Tiantan Hospital, Capital Medical University
Outcome results
None listed