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Efficacy of Temozolomide therapy in patients with aggressive pituitary adenomas and carcinomas: a German survey

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.We therefore aimed to report on clinical characteristics leading to initiation of TMZ therapy and to add...

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Main Authors: Elbelt, Ulf (Author) , Schlaffer, Sven-Martin (Author) , Buchfelder, Michael (Author) , Knappe, Ulrich Johannes (Author) , Vila, Greisa (Author) , Micko, Alexander (Author) , Deutschbein, Timo (Author) , Unger, Nicole (Author) , Lammert, Alexander (Author) , Topuzoglu-Müller, Tengü (Author) , Bojunga, Jörg (Author) , Droste, Michael (Author) , Johanssen, Sarah (Author) , Kolenda, Herbert (Author) , Ritzel, Katrin (Author) , Buslei, Rolf (Author) , Strasburger, Christian J. (Author) , Petersenn, Stephan (Author) , Honegger, Jürgen (Author)
Format: Article (Journal)
Language:English
Published: 20 November 2019
In: The journal of clinical endocrinology & metabolism
Year: 2020, Volume: 105, Issue: 3, Pages: e660-e675
ISSN:1945-7197
DOI:10.1210/clinem/dgz211
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1210/clinem/dgz211
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Author Notes:Ulf Elbelt, Sven M. Schlaffer, Michael Buchfelder, Ulrich J. Knappe, Greisa Vila, Alexander Micko, Timo Deutschbein, Nicole Unger, Alexander Lammert, Tengü Topuzoglu-Müller, Jörg Bojunga, Michael Droste, Sarah Johanssen, Herbert Kolenda, Katrin Ritzel, Rolf Buslei, Christian J. Strasburger, Stephan Petersenn, and Jürgen Honegger, on behalf of the Pituitary Working Group of the German Society for Endocrinology
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Summary: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.We therefore aimed to report on clinical characteristics leading to initiation of TMZ therapy and to add evidence on TMZ long-term effectiveness.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.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.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.
Item Description:Gesehen am 24.06.2021
Physical Description:Online Resource
ISSN:1945-7197
DOI:10.1210/clinem/dgz211

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