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

• 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.Electronic survey to ESE members Dec 2015-Nov 2016.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%.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.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Endokrinologi och diabetes (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Endocrinology and Diabetes (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Cancer och onkologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cancer and Oncology (hsv//eng)

Nyckelord

Adenoma

metabolism

pathology

therapy

Adolescent

Adult

Aged

Antineoplastic Agents

Alkylating

therapeutic use

Antineoplastic Combined Chemotherapy Protocols

therapeutic use

Bevacizumab

administration & dosage

Capecitabine

administration & dosage

Carcinoma

metabolism

pathology

therapy

Carmustine

administration & dosage

Child

Child

Preschool

Cranial Irradiation

DNA Modification Methylases

metabolism

DNA Repair Enzymes

metabolism

Dacarbazine

administration & dosage

analogs & derivatives

therapeutic use

Endocrinology

Europe

Female

Humans

Ki-67 Antigen

metabolism

Male

Middle Aged

Neoplasm Invasiveness

Neurosurgical Procedures

Pituitary Neoplasms

metabolism

pathology

therapy

Societies

Medical

Surveys and Questionnaires

Temozolomide

Thalidomide

administration & dosage

Tumor Suppressor Proteins

metabolism

Young Adult

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