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Long-Term Outcome and MGMT as a Predictive Marker in 24 Patients With Atypical Pituitary Adenomas and Pituitary Carcinomas Given Treatment With Temozolomide

Bengtsson, Daniel, 1975- (författare)
Linköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten
Schroder, H. D. (författare)
Department of Pathology (H.D.S.) Odense, Denmark
Andersen, M. (författare)
Department of Endocrinology (M.A.), Odense University Hospital, University of Southern Denmark, Odense, Denmark
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Maiter, D. (författare)
Department of Endocrinology and Nutrition (D.M.), Cliniques Universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium
Berinder, K. (författare)
Karolinska Institutet,Department of Endocrinology, Metabolism and Diabetology (K.B., C.H., M.P.), Karolinska University Hospital, Stockholm, Sweden
Rasmussen, U. F. (författare)
Department of Medical Endocrinology and Metabolism (U.F.R, Å.K.R), Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
Rasmussen, A. K. (författare)
Department of Medical Endocrinology and Metabolism (U.F.R, Å.K.R), Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
Johannsson, Gudmundur, 1960 (författare)
Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition,Department of Endocrinology (G.J., O.R.), Institute of Medicine, Sahlgrenska Academy, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
Hoybye, C. (författare)
Karolinska Institutet,Department of Endocrinology, Metabolism and Diabetology (K.B., C.H., M.P.), Karolinska University Hospital, Stockholm, Sweden
van der Lely, A. J. (författare)
Department of Medicine, Division of Endocrinology (A.J.v.d.L.), Erasmus University MC, Rotterdam, The Netherlands
Petersson, M. (författare)
Karolinska Institutet,Department of Endocrinology, Metabolism and Diabetology (K.B., C.H., M.P.), Karolinska University Hospital, Stockholm, Sweden
Ragnarsson, Oskar, 1971 (författare)
Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition,Institute of Medicine, Department of Internal Medicine and Clinical Nutrition,Department of Endocrinology (G.J., O.R.), Institute of Medicine, Sahlgrenska Academy, University of Gothenburg; Sahlgrenska University Hospital, Gothenburg, Sweden
Burman, Pia (författare)
Lund University,Lunds universitet,Genomik, diabetes och endokrinologi,Forskargrupper vid Lunds universitet,Genomics, Diabetes and Endocrinology,Lund University Research Groups,Department of Endocrinology (D.B., P.B.), Skane University Hospital, Malmö, Sweden
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 (creator_code:org_t)
The Endocrine Society, 2015
2015
Engelska.
Ingår i: Journal of Clinical Endocrinology & Metabolism. - : The Endocrine Society. - 0021-972X .- 1945-7197. ; 100:4, s. 1689-1698
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
Stäng  
  • Context/Objective: Locally aggressive pituitary tumors (LAPT) and pituitary carcinomas respond poorly to conventional therapy and cytotoxic drugs. Temozolomide (TMZ) is an oral alkylating drug with good tolerability, approved for treatment of malignant gliomas. The experience of its use in pituitary tumors is limited. Design and Setting: We report on 24 patients with aggressive pituitary tumors (16 LAPTs, 8 carcinomas) treated with TMZ for a median of 6 months (range 1-23). Follow-up ranged from 4 to 91 months with a median of 32.5 months. 19/24 tumors were hormone secreting (PRL 9, ACTH 4, GH 4, GH/PRL 2). Ki-67 was 2-50% in LAPTs, and 5-80% in carcinomas. Main Outcome: Response to TMZ and the association with tumor expression of O6-methylguanine DNA methyltransferase (MGMT), MLH1, MSH2, and MSH6, examined by immunohistochemistry. Results: Complete tumor regression occurred in two carcinomas and persisted at follow-up after 48 and 91 months, respectively. Partial regress of tumor mass ranging from 35% to 80% occurred in 5 LAPTs and 2 carcinomas. Another patient with LAPT had a 71% decrease in prolactin levels without change in tumor volume. Three LAPTs could not be evaluated. Median MGMT staining was 9% (5-20%) in responders vs 93% (50-100%) in nonresponders. Loss of MSH2 and MSH 6 was observed in a single patient who had a rapid development of resistance to TMZ. Conclusions: This study shows that TMZ is a valuable treatment option for patients with uncontrolled pituitary tumors. The data suggest that tumoral MGMT staining below 50% is associated with a high likelihood of treatment response.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine (hsv//eng)
MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)

Nyckelord

O-6-METHYLGUANINE DNA METHYLTRANSFERASE
REPAIR PROTEIN MSH6
OF-THE-LITERATURE
PROMOTER METHYLATION
MALIGNANT GLIOMA
TUMORS
GLIOBLASTOMA
EXPERIENCE
RESISTANT
THERAPY
Endocrinology & Metabolism

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