TY - JOUR
T1 - Treatment of aggressive pituitary tumours and carcinomas
T2 - Results of a European Society of Endocrinology (ESE) survey 2016
AU - ESE survey collaborators
AU - McCormack, Ann
AU - Dekkers, Olaf M.
AU - Petersenn, Stephan
AU - Popovic, Vera
AU - Trouillas, Jacqueline
AU - Raverot, Gerald
AU - Burman, Pia
AU - Harrison, Alex
AU - Hubalewska-Dydejezky, Alicia
AU - Assie, Guillaume
AU - Bach, Leon
AU - Batisse-Lignier, Marie
AU - Berinder, Katarina
AU - Bilbao, Ismene
AU - Bonnet, Fabrice
AU - Bresson, Damien
AU - Bruno, Oscar
AU - Campdera, Mariana
AU - Caron, Philippe
AU - Castinetti, Frederic
AU - Ceccato, Filippo
AU - Chabre, Olivier
AU - Chanson, Philippe
AU - Christ, Emanuel
AU - Cloix, Lucie
AU - Cortet, Christine
AU - Criniere, Lise
AU - Cuatrecasas, Guillem
AU - Debono, Miguel
AU - Delemer, Brigitte
AU - Desailloud, Rachel
AU - Deutschbein, Timo
AU - Dusek, Tina
AU - Engström, Britt Eden
AU - Faustini-Fustini, Marco
AU - Franck, Schillo
AU - Garcia, Cyril
AU - Greenman, Yona
AU - Gil, Susana Mallea
AU - Mantovani, Giovanna
AU - Gurnell, Mark
AU - Heaney, Anthony
AU - Henley, David
AU - Higham, Claire
AU - Hoving, E. W.
AU - Höybye, Charlotte
AU - Ichihara, Atsuhiro
AU - Jaffrain-Rea, Marie Lise
AU - Johannsson, Gudmundur
AU - Neggers, Sebastian
N1 - Publisher Copyright:
© 2018 European Society of Endocrinology.
PY - 2018/3
Y1 - 2018/3
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85042463566&partnerID=8YFLogxK
U2 - 10.1530/EJE-17-0933
DO - 10.1530/EJE-17-0933
M3 - Review article
C2 - 29330228
AN - SCOPUS:85042463566
SN - 0804-4643
VL - 178
SP - 265
EP - 276
JO - European Journal of Endocrinology
JF - European Journal of Endocrinology
IS - 3
ER -