Effective long-term temozolomide rechallenge in a macroprolactinoma

Benedetta Zampetti, Giorgia Simonetti, Roberto Attanasio, Antonio Silvani, Renato Cozzi

Research output: Contribution to journalArticle

Abstract

We describe the 20-year course of a 63-year-old male with a macroprolactinoma that acquired resistance to treatment and aggressive behavior after a 4-year successful treatment with cabergoline. He was submitted to multiple surgical resections by a skilled surgeon, fractionated radiotherapy and was eventually treated with temozolomide. After a first 6-month standard cycle, a relapse occurred and he was treated again successfully. Learning points: •• Prolactinomas are the most frequent type of pituitary adenoma. •• They usually have a benign course. •• In most cases dopamine-agonist drugs, mainly cabergoline, are first-line (and usually only) treatment. •• Occasionally prolactinomas can have or acquire resistance to treatment and/or aggressive behavior. •• Temozolomide (TMZ), an oral alkylating drug, can be effective in such aggressive tumors. •• Multimodal treatment (surgery, radiation, cabergoline and TMZ) is warranted in aggressive pituitary tumors. •• We describe here successful rechallenge with TMZ after relapse occurring 18 months after a first TMZ cycle.

Original languageEnglish
JournalEndocrinology, diabetes & metabolism case reports
Volume2018
DOIs
Publication statusPublished - Sep 25 2018

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temozolomide
Prolactinoma
Pituitary Neoplasms
Recurrence
Combined Modality Therapy
Dopamine Agents
Dopamine Agonists
Therapeutics
Radiotherapy
Learning
Radiation

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Effective long-term temozolomide rechallenge in a macroprolactinoma. / Zampetti, Benedetta; Simonetti, Giorgia; Attanasio, Roberto; Silvani, Antonio; Cozzi, Renato.

In: Endocrinology, diabetes & metabolism case reports, Vol. 2018, 25.09.2018.

Research output: Contribution to journalArticle

Zampetti, Benedetta ; Simonetti, Giorgia ; Attanasio, Roberto ; Silvani, Antonio ; Cozzi, Renato. / Effective long-term temozolomide rechallenge in a macroprolactinoma. In: Endocrinology, diabetes & metabolism case reports. 2018 ; Vol. 2018.
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AU - Simonetti, Giorgia

AU - Attanasio, Roberto

AU - Silvani, Antonio

AU - Cozzi, Renato

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N2 - We describe the 20-year course of a 63-year-old male with a macroprolactinoma that acquired resistance to treatment and aggressive behavior after a 4-year successful treatment with cabergoline. He was submitted to multiple surgical resections by a skilled surgeon, fractionated radiotherapy and was eventually treated with temozolomide. After a first 6-month standard cycle, a relapse occurred and he was treated again successfully. Learning points: •• Prolactinomas are the most frequent type of pituitary adenoma. •• They usually have a benign course. •• In most cases dopamine-agonist drugs, mainly cabergoline, are first-line (and usually only) treatment. •• Occasionally prolactinomas can have or acquire resistance to treatment and/or aggressive behavior. •• Temozolomide (TMZ), an oral alkylating drug, can be effective in such aggressive tumors. •• Multimodal treatment (surgery, radiation, cabergoline and TMZ) is warranted in aggressive pituitary tumors. •• We describe here successful rechallenge with TMZ after relapse occurring 18 months after a first TMZ cycle.

AB - We describe the 20-year course of a 63-year-old male with a macroprolactinoma that acquired resistance to treatment and aggressive behavior after a 4-year successful treatment with cabergoline. He was submitted to multiple surgical resections by a skilled surgeon, fractionated radiotherapy and was eventually treated with temozolomide. After a first 6-month standard cycle, a relapse occurred and he was treated again successfully. Learning points: •• Prolactinomas are the most frequent type of pituitary adenoma. •• They usually have a benign course. •• In most cases dopamine-agonist drugs, mainly cabergoline, are first-line (and usually only) treatment. •• Occasionally prolactinomas can have or acquire resistance to treatment and/or aggressive behavior. •• Temozolomide (TMZ), an oral alkylating drug, can be effective in such aggressive tumors. •• Multimodal treatment (surgery, radiation, cabergoline and TMZ) is warranted in aggressive pituitary tumors. •• We describe here successful rechallenge with TMZ after relapse occurring 18 months after a first TMZ cycle.

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