Efficacy of Temozolomide Therapy in Patients With Aggressive Pituitary Adenomas and Carcinomas-A German Survey.

Autor:	Elbelt U; Department of Endocrinology, Diabetes and Nutrition, Charité-Universitätsmedizin Berlin, Berlin, Germany., Schlaffer SM; Department of Neurosurgery, University of Erlangen-Nuremberg, Erlangen, Germany., Buchfelder M; Department of Neurosurgery, University of Erlangen-Nuremberg, Erlangen, Germany., Knappe UJ; Department of Neurosurgery, Johannes Wesling Klinikum, Universitätsklinikum der Ruhruniversität Bochum, Minden, Germany., Vila G; Department of Internal Medicine III, Division of Endocrinology and Metabolism, Medical University Vienna, Vienna, Austria., Micko A; Department of Neurosurgery, Medical University Vienna, Vienna, Austria., Deutschbein T; Department of Internal Medicine I, Division of Endocrinology and Diabetes, University Hospital Würzburg, University of Würzburg, Würzburg, Germany., Unger N; Department of Endocrinology, Diabetes and Metabolism, University Hospital Essen, Essen, Germany., Lammert A; Vth Department of Medicine, Medical Faculty Mannheim of the University of Heidelberg, Mannheim, Germany., Topuzoglu-Müller T; Department of Endocrinology, Diabetes and Preventive Medicine, University Hospital of Cologne, Cologne, Germany., Bojunga J; Department of Internal Medicine 1, Johann Wolfgang Goethe-University Hospital, Frankfurt, Germany., Droste M; Medicover Oldenburg MVZ, Oldenburg, Germany., Johanssen S; Endokrinologikum Berlin, Berlin, Germany., Kolenda H; Department of Neurosurgery, Agaplesion Diakonieklinikum Rotenburg, Rotenburg, Germany., Ritzel K; Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Munich, Germany., Buslei R; Institute of Pathology, SozialStiftung Bamberg, Bamberg, Germany., Strasburger CJ; Department of Endocrinology, Diabetes and Nutrition, Charité-Universitätsmedizin Berlin, Berlin, Germany., Petersenn S; ENDOC Center for Endocrine Tumors, Hamburg, Germany., Honegger J; Department of Neurosurgery, University of Tuebingen, Tuebingen, Germany.
Jazyk:	angličtina
Zdroj:	The Journal of clinical endocrinology and metabolism [J Clin Endocrinol Metab] 2020 Mar 01; Vol. 105 (3).
DOI:	10.1210/clinem/dgz211
Abstrakt:	Context: Despite growing evidence that temozolomide (TMZ) therapy is effective for the treatment of aggressive pituitary tumors (APTs) or carcinomas (PCs), individual therapy decisions remain challenging. Objective: We therefore aimed to report on clinical characteristics leading to initiation of TMZ therapy and to add evidence on TMZ long-term effectiveness. Design and Subjects: Retrospective survey on TMZ treatment in patients with APTs or PCs. TMZ therapy was initiated in 47 patients (22 females) with APTs (n = 34) or PCs (n = 13). Mean age at diagnosis was 45 ± 15 years. The immunohistochemical subtypes were corticotroph (n = 20), lactotroph (n = 18), and nonfunctioning (n = 9) tumors. TMZ therapy started 8 years after initial diagnosis using a standard regimen (median 6 cycles) for the majority of patients. Results: Long-term radiological response to TMZ after a median follow-up of 32 months with 4 patients still on TMZ therapy was tumor regression for 9 (20%), stable disease for 8 (17%), and tumor progression for 29 patients (63%) (outcome data available for 46 patients). Progression occurred 16 months after initiation of TMZ. Median estimated progression-free survival was 23 months. Disease stabilization and median progression-free survival did not differ between patients with APTs or PCs. Predictors of tumor response were not identified. Overall, TMZ was well tolerated. Conclusion: We performed a nationwide survey on TMZ therapy in patients with APTs and PCs. While early response rates to TMZ are promising, long-term outcome is less favorable. Prolonged TMZ administration should be considered. We were not able to confirm previously reported predictors of tumor response to TMZ. (© Endocrine Society 2019. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
Databáze:	MEDLINE
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