Treatment of aggressive pituitary tumours and carcinomas: results of a European Society of Endocrinology (ESE) survey 2016. Issue 3 (March 2018)

• Record Type: Journal Article
• Authors: McCormack, Ann; Dekkers, Olaf M; Petersenn, Stephan; Popovic, Vera; Trouillas, Jacqueline; Raverot, Gerald; Burman, Pia
• Other Names: author non-byline.; Hubalewska-Dydejezky Alicia author non-byline.; Assie Guillaume author non-byline.; Bach Leon author non-byline.; Batisse-Lignier Marie author non-byline.; Berinder Katarina author non-byline.; Bilbao Ismene author non-byline.; Bonnet Fabrice author non-byline.; Bresson Damien author non-byline.; Bruno Oscar author non-byline.; Campdera Mariana author non-byline.; Caron Philippe author non-byline.; Castinetti Frederic author non-byline.; Ceccato Filippo author non-byline.; Chabre Olivier author non-byline.; Chanson Philippe author non-byline.; Christ Emanuel author non-byline.; Cloix Lucie author non-byline.; Cortet Christine author non-byline.; Criniere Lise author non-byline.; Cuatrecasas Guillem author non-byline.; Debono Miguel author non-byline.; Delemer Brigitte author non-byline.; Desailloud Rachel author non-byline.; Deutschbein Timo author non-byline.; Dusek Tina author non-byline.; Engström Britt Eden author non-byline.; Faustini-Fustini Marco author non-byline.; Franck Schillo author non-byline.; Garcia Cyril author non-byline.; Greenman Yona author non-byline.; Gil Susana Mallea author non-byline.; Mantovani Giovanna author non-byline.; Gurnell Mark author non-byline.; Heaney Anthony author non-byline.; Henley David author non-byline.; Higham Claire author non-byline.; Hoving EW author non-byline.; Höybye Charlotte author non-byline.; Ichihara Atsuhiro author non-byline.; Jaffrain-Rea Marie-Lise author non-byline.; Johannsson Gudmundur author non-byline.; Jorgensen Jens Otto Lunde author non-byline.; Jublanc Christel author non-byline.; Komor Jan author non-byline.; Korbonits Marta author non-byline.; Kralievic Ivana author non-byline.; Larrieu-Ciron Delphine author non-byline.; Lasolle Helene author non-byline.; Laws Edward author non-byline.; Losa Marco author non-byline.; Maiter Dominique author non-byline.; Marcocci Claudio author non-byline.; Marques Olinda Castro author non-byline.; Mazzuco Tania Longo author non-byline.; Micko Alexander author non-byline.; Bourcigaux Nathalie author non-byline.; Neggers Sebastian author non-byline.; Newell-Price John author non-byline.; Perez-Berida Belén author non-byline.; Ortiz Leon D author non-byline.; Ragnarsson Oskar author non-byline.; Ragonese Marta author non-byline.; Reincke Martin author non-byline.; Sadoul Jean-Louis author non-byline.; Shimatsu Akira author non-byline.; Syro Luis V author non-byline.; Taillandier Luc author non-byline.; Toth Miklos author non-byline.; Usui Takeshi author non-byline.; Valkusz Zauzsanna author non-byline.; Vila Greisa author non-byline.; Whitelaw Ben author non-byline.; Zatelli Maria Chiara author non-byline.;
• Is Part Of: European journal of endocrinology. Volume 178:Issue 3(2018)
• Page Start: 265
• Page End: 276
• Publication Date: 2018-03
• Subjects: Endocrinology -- Periodicals; 616.4005
• DOI: 10.1530/EJE-17-0933
• Languages: English
• ISSNs: 0804-4643

Abstract

Abstract : Objective: To collect outcome data in a large cohort of patients with aggressive pituitary tumours (APT)/carcinomas (PC) and specifically report effects of temozolomide (TMZ) treatment. Design: Electronic survey to ESE members Dec 2015–Nov 2016. Results: Reports on 166 patients (40 PC, 125 APT, 1 unclassified) were obtained. Median age at diagnosis was 43 (range 4–79) years. 69% of the tumours were clinically functioning, and the most frequent immunohistochemical subtype were corticotroph tumours (45%). Ki-67 index did not distinguish APT from PC, median 7% and 10% respectively. TMZ was first-line chemotherapy in 157 patients. At the end of the treatment (median 9 cycles), radiological evaluation showed complete response (CR) in 6%, partial response (PR) in 31%, stable disease (SD) in 33% and progressive disease in 30%. Response was more frequent in patients receiving concomitant radiotherapy and TMZ. CR was seen only in patients with low MGMT expression. Clinically functioning tumours were more likely to respond than non-functioning tumours, independent of MGMT status. Of patients with CR, PR and SD, 25, 40 and 48% respectively progressed after a median of 12-month follow-up. Other oncological drugs given as primary treatment and to TMZ failures resulted in PR in 20%. Conclusion: This survey confirms that TMZ is established as first-line chemotherapeutic treatment of APT/PC. Clinically functioning tumours, low MGMT and concurrent radiotherapy were associated with a better response. The limited long-term effect of TMZ and the poor efficacy of other drugs highlight the need to identify additional effective therapies.