177Lu-DOTATATE for Recurrent Meningioma

Inclusion Criteria: * Adult patient ≥ 18 years of age * Histologically confirmed diagnosis of meningioma (all grades, 1-3 per WHO CNS5, are eligible) * WHO performance status 0-2 * Measurable disease (at least 10 x10 mm contrast enhancing lesion) on cranial MRI no more than two weeks prior to randomization * Radiologically documented progression of any existing tumour (growth \> 25% in the last two years) or appearance of new lesions (including intra- and extracranial manifestations) * Somatostatin receptor (SSTR)-positive confirmed by PET imaging with scan performed within four weeks before randomization (baseline SSTR-PET is considered as positive when meningioma uptake intensity exceeds a SUVmax of 2.3). * At least one prior surgery and one line of external beam radiotherapy for meningioma * Adequate liver, renal and haematological function within four weeks prior to randomization (1) Neutrophils ≥ 1.5 x 109/L, hemoglobin ≥ 9 g/dL or hemoglobin ≥ 5.6 mmol/L, platelets ≥ 100 x 109/L, (2) Total Bilirubin ≤ 1 x ULN, SGPT/ALT and SGOT/AST ≤ 2.5 x ULN, (3) Albumin ≥ 30 g/L, (4) Serum creatinine ≤ 1.5 x ULN, (5) Creatinine clearance \> 40 ml/min as calculated by CKD-EPI 2021 * Participants must have the following electrolyte values within normal limits or corrected to be within normal limits with supplements prior to first dose of study medication: (1) Potassium (potassium level of up to 6.0 mmol/L is acceptable at study entry if associated with creatinine clearance within norm…