Trabectedin for Recurrent Grade II/III Meningioma

Patient selection criteria * Age 18 or older * Histological diagnosis of World Health Organization (WHO) grade II (chordoid meningioma, clear cell meningioma, atypical meningioma) or WHO grade III (papillary meningioma, rhabdoid meningioma, anaplastic/malignant meningioma) according to WHO 2007 classification. * Radiologically documented progression of any existing tumor (growth \> 25% in the last year) or appearance of new lesions (including intra- and extracranial manifestations) * No more option for local therapy (resection or radiotherapy) after maximal feasible surgery and radiotherapy * No prior systemic anti-neoplastic therapy for meningioma * Measurable disease (10 x10 mm) on cranial MRI no more than 2 weeks prior to randomization. * WHO performance status 0-2 * Adequate liver, renal and hematological function within 4 weeks prior to randomization, defined as: * Neutrophils ≥ 1.5 x 109/L, hemoglobin ≥ 9 g/dL or hemoglobin ≥ 5.6 mmol/L, platelets ≥ 100 x 109/L * Total Bilirubin ≤ 1 x Upper Limit of Normal (ULN), serum glutamate pyruvate transaminase(SGPT)/ Alanine Aminotransferase (ALT) and serum glutamate oxaloacetate transaminase (SGOT)/ Aspartate Aminotransferase (AST) ≤ 2.5 x ULN * Alkaline phosphatase ≤ 2.5 x ULN; if alkaline phosphatase \> 2.5 ULN, Alkaline Phosphatase (ALP) hepatic isoenzyme and/or 5-nucleotidase and/or gamma glutamyltransferase (GGT) must be within the normal range * Albumin ≥ 30 g/L * Serum creatinine ≤ 1.5 x ULN * Creatinine cle…