The role of temozolomide in the treatment of aggressive pituitary tumors

Liu, James K.; Patel, Jignesh; Eloy, Jean Anderson

doi:10.1016/j.jocn.2014.12.007

Cited by 34 publications

(28 citation statements)

References 71 publications

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“…32 Previous case reports suggested that the alkylating agent TMZ was very effective in treating patients with aggressive prolactinomas/carcinomas. 28,33 Approximately 105 pituitary tumor patients treated with TMZ have been reported in the literature with variable outcomes.…”

Section: Discussionmentioning

confidence: 99%

Temozolomide therapy for resistant prolactin-secreting pituitary adenomas and carcinomas: a systematic review

Almalki

Aljoaib

Alotaibi

et al. 2017

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Pituitary tumors represent 10-15% of all intracranial tumors; of these, prolactinomas account for 40-50% of cases. Prolactinomas usually respond well to dopamine agonists (DA) as firstline therapy. However, treatment resistance remains a concern. Temozolomide (TMZ) is an oral alkylating agent that has shown promise in treating aggressive pituitary adenomas and carcinomas that are resistant to other therapies. To date, no control trials have been undertaken and only single case reports of pituitary tumors treated with TMZ have been published. A systematic literature search was conducted for studies reporting the use of TMZ for the treatment of prolactinomas that were resistant to standard therapy. In total, 42 reported cases were identified and included in our analysis: 23 cases of prolactin-secreting adenomas and 19 of prolactin-secreting carcinomas. Prior to TMZ administration, patients had exhibited tumor progression and had previously undergone various treatments including surgery, radiotherapy, and drug therapy. Tumor shrinkage was reported in 76% of patients. Reduced prolactin levels were observed in 75% of patients, while normalization of prolactin was reported in 8%. TMZ failure occurred in 20.6% of cases. Most patients exhibited no serious adverse effects. In conclusion, TMZ has potential for the treatment of highly aggressive and resistant prolactin-secreting adenomas and carcinomas, as demonstrated by tumor shrinkage or complete response and normalization of hormone hypersecretion, and exhibits good tolerability and few side effects.

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Section: Discussionmentioning

confidence: 99%

Temozolomide therapy for resistant prolactin-secreting pituitary adenomas and carcinomas: a systematic review

Almalki

Aljoaib

Alotaibi

et al. 2017

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“…Recently, the upregulation of mitogen-activated protein kinase has also been reported in gangliogliomas [37]. Moreover, when the methylation status of O(6)-methylguanine DNA methyltransferase (MGMT) was examined in pituitary adenomas, the degree of MGMT expression appeared to be related to therapeutic responses to temozolomide [1,24,26]. MGMT protein expression was also implicated as a prognostic factor for patients with low-grade gangliogliomas [11].…”

Section: Discussionmentioning

confidence: 99%

Ganglion cell tumours in the sella turcica in close morphological connection with pituitary adenomas

Matyja

Maksymowicz²,

Grajkowska³

et al. 2015

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“…This tumor exhibited a high rate of proliferation, indicating that it might have been sensitive to chemotherapy. Temozolomide (TMZ), an alkylating chemotherapy drug that was approved for use in glioblastoma therapy, has been used to successfully treat pituitary carcinomas, and it has more recently been used to treat invasive and/or recurrent pituitary adenomas [9]. M Losa et al reported that temozolomide treatment had a wide range of efficacy in patients with pituitary carcinoma or locally aggressive pituitary adenoma and positive staining for MGMT seems likely to predict a lower chance of response [10].…”

Section: Discussionmentioning

confidence: 99%

An atypical pituitary adenoma with a high degree of malignancy: a case report

et al. 2017

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Background: Pituitary carcinoma is very rare and hard to diagnose. However, some atypical pituitary adenomas present with a high rate of proliferation and extensive invasion, suggesting a tumor with a high degree of malignancy. Case presentation: Here, we present a case study of this type of tumor. A 46 years old women was admitted for headaches and impaired vision, and MRI and CT revealed a sellar lesion. She underwent a transsphenoidal surgery followed by radiotherapy, but the tumor recurred only one month later. She decided to undergo a second and third operation. The final pathology showed a non-functioning adenoma that was approximately 80% ki-67-positive and extensively p53-positive. No metastasis was found. The tumor progressed extremely quickly, and the patient died 7 months after the initial diagnosis. Conclusions: A pituitary adenoma like this should be treated like a carcinoma, and early treatment may increase the likelihood of survival. A traditional diagnosis standard is unfit for this type of tumor.

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The role of temozolomide in the treatment of aggressive pituitary tumors

Cited by 34 publications

References 71 publications

Temozolomide therapy for resistant prolactin-secreting pituitary adenomas and carcinomas: a systematic review

Temozolomide therapy for resistant prolactin-secreting pituitary adenomas and carcinomas: a systematic review

Ganglion cell tumours in the sella turcica in close morphological connection with pituitary adenomas

An atypical pituitary adenoma with a high degree of malignancy: a case report

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