Temozolomide therapy in patients with aggressive pituitary adenomas or carcinomas

Marco Losa, Fausto Bogazzi, Salvo Cannavo, Filippo Ceccato, L. Curtò, Laura De Marinis, Donato Iacovazzo, Giuseppe Lombardi, Giovanna Mantovani, Elena Aurelia Mazza, Giuseppe Minniti, Maurizio Nizzoli, Michele Reni, C. Scaroni

Research output: Contribution to journalArticle

Abstract

Temozolomide is effective in some patients with progressive pituitary adenoma or carcinoma. We report a survey study of Italian patients treated with Temozolomide because of aggressive pituitary adenoma or carcinoma resistant to standard therapies. Italian endocrinologists were surveyed and asked to participate into the study. A questionnaire was sent to all those who agreed and had used Temozolomide in at least one patient with pituitary tumor. Database was closed in December 2013. A literature review was also performed. Thirty-one patients were included into the analysis. Mean age at start of Temozolomide treatment was 58.3 ± 1.9 years (± standard error). Six of the 31 (19.4 %) Italian patients had a pituitary carcinoma. Twenty-five patients (80.6 %) had disease control during Temozolomide treatment, while 6 patients (19.4 %) had disease progression. Median follow-up after beginning Temozolomide was 43 months. Thirteen patients had tumor growth after stopping Temozolomide. The 2-year progression-free survival was 47.7 % (95 % CI 29.5–65.9 %), while the 2-year disease control duration was 59.1 % (95 % CI 39.1–79.1 %). Eleven patients died of progressive disease and other two patients of unrelated causes. The 2-year and 4-year overall survival rates were 83.9 % (95 % CI 70.7–97.1 %) and 59.6 % (95 % CI 40.0–79.2 %), respectively. Temozolomide is an additional effective therapeutic option for the treatment of aggressive pituitary tumors. The drug is well tolerated and causes few severe adverse effects. Recurrence of the tumor can occur after an initial positive response and usually portends a grim outcome.

Original languageEnglish
Pages (from-to)519-525
Number of pages7
JournalJournal of Neuro-Oncology
Volume126
Issue number3
DOIs
Publication statusPublished - Feb 1 2016

Keywords

  • Chemotherapy
  • Pituitary carcinoma
  • Pituitary neoplasm
  • Pituitary surgery
  • Temozolomide

ASJC Scopus subject areas

  • Clinical Neurology
  • Cancer Research
  • Oncology
  • Neurology

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  • Cite this

    Losa, M., Bogazzi, F., Cannavo, S., Ceccato, F., Curtò, L., De Marinis, L., Iacovazzo, D., Lombardi, G., Mantovani, G., Mazza, E. A., Minniti, G., Nizzoli, M., Reni, M., & Scaroni, C. (2016). Temozolomide therapy in patients with aggressive pituitary adenomas or carcinomas. Journal of Neuro-Oncology, 126(3), 519-525. https://doi.org/10.1007/s11060-015-1991-y