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

McCormack, Ann; Dekkers, Olaf M.; Petersenn, Stephan; Popovic, Vera; Trouillas, Jacqueline; Raverot, Gerald and Burman, Pia LU (2018) In European journal of endocrinology 178(3). p.265-276
Abstract

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... (More)

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.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
European journal of endocrinology
volume
178
issue
3
pages
12 pages
publisher
Society of the European Journal of Endocrinology
external identifiers
  • scopus:85042463566
ISSN
1479-683X
DOI
10.1530/EJE-17-0933
language
English
LU publication?
yes
id
bbb59714-0b80-40e8-b883-237ea64678d4
date added to LUP
2018-03-17 19:27:24
date last changed
2018-09-16 04:54:03
@article{bbb59714-0b80-40e8-b883-237ea64678d4,
  abstract     = {<p>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.</p><p>DESIGN: Electronic survey to ESE members Dec 2015-Nov 2016.</p><p>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%.</p><p>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.</p>},
  author       = {McCormack, Ann and Dekkers, Olaf M. and Petersenn, Stephan and Popovic, Vera and Trouillas, Jacqueline and Raverot, Gerald and Burman, Pia},
  issn         = {1479-683X},
  language     = {eng},
  month        = {03},
  number       = {3},
  pages        = {265--276},
  publisher    = {Society of the European Journal of Endocrinology},
  series       = {European journal of endocrinology},
  title        = {Treatment of aggressive pituitary tumours and carcinomas : results of a European Society of Endocrinology (ESE) survey 2016},
  url          = {http://dx.doi.org/10.1530/EJE-17-0933},
  volume       = {178},
  year         = {2018},
}