1. Treatment of aggressive pituitary tumours and carcinomas: Results of a European Society of Endocrinology (ESE) survey 2016
- Author
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Ann McCormack, Olaf M Dekkers, Stephan Petersenn, Vera Popovic, Jacqueline Trouillas, Gerald Raverot, Pia Burman, Alicia Hubalewska-Dydejezky, Guillaume Assie, Leon Bach, Marie Batisse-Lignier, Katarina Berinder, Ismene Bilbao, Fabrice Bonnet, Damien Bresson, Oscar Bruno, Mariana Campdera, Philippe Caron, Frederic Castinetti, Filippo Ceccato, Olivier Chabre, Philippe Chanson, Emanuel Christ, Lucie Cloix, Christine Cortet, Lise Criniere, Guillem Cuatrecasas, Miguel Debono, Brigitte Delemer, Rachel Desailloud, Timo Deutschbein, Tina Dusek, Britt Eden Engström, Marco Faustini-Fustini, Schillo Franck, Cyril Garcia, Yona Greenman, Susana Mallea Gil, Giovanna Mantovani, Mark Gurnell, Anthony Heaney, David Henley, Claire Higham, EW Hoving, Charlotte Höybye, Atsuhiro Ichihara, Marie-Lise Jaffrain-Rea, Gudmundur Johannsson, Jens Otto Lunde Jorgensen, Christel Jublanc, Jan Komor, Marta Korbonits, Ivana Kralievic, Delphine Larrieu-Ciron, Helene Lasolle, Edward Laws, Marco Losa, Dominique Maiter, Claudio Marcocci, Olinda Castro Marques, Tania Longo Mazzuco, Alexander Micko, Nathalie Bourcigaux, Sebastian Neggers, John Newell-Price, Belén Perez-Berida, Leon D Ortiz, Oskar Ragnarsson, Marta Ragonese, Martin Reincke, Jean-Louis Sadoul, Akira Shimatsu, Luis V Syro, Luc Taillandier, Miklos Toth, Takeshi Usui, Zauzsanna Valkusz, Greisa Vila, Ben Whitelaw, Maria Chiara Zatelli, Mccormack, Ann, Dekkers, Olaf M, Petersenn, Stephan, Popovic, Vera, Trouillas, Jacqueline, Raverot, Gerald, Burman, Pia, Harrison, Alex, Hubalewska-Dydejezky, Alicia, Assie, Guillaume, Bach, Leon, Batisse-Lignier, Marie, Berinder, Katarina, Bilbao, Ismene, Bonnet, Fabrice, Bresson, Damien, Bruno, Oscar, Campdera, Mariana, Caron, Philippe, Castinetti, Frederic, Ceccato, Filippo, Chabre, Olivier, Chanson, Philippe, Christ, Emanuel, Cloix, Lucie, Cortet, Christine, Criniere, Lise, Cuatrecasas, Guillem, Debono, Miguel, Delemer, Brigitte, Desailloud, Rachel, Deutschbein, Timo, Dusek, Tina, Engström, Britt Eden, Faustini-Fustini, Marco, Franck, Schillo, Garcia, Cyril, Greenman, Yona, Gil, Susana Mallea, Mantovani, Giovanna, Gurnell, Mark, Heaney, Anthony, Henley, David, Higham, Claire, Hoving, E. W., Höybye, Charlotte, Ichihara, Atsuhiro, Jaffrain-Rea, Marie-Lise, Johannsson, Gudmundur, Jorgensen, Jens Otto Lunde, Jublanc, Christel, Komor, Jan, Korbonits, Marta, Kralievic, Ivana, Larrieu-Ciron, Delphine, Lasolle, Helene, Laws, Edward, Losa, Marco, Maiter, Dominique, Marcocci, Claudio, Marques, Olinda Castro, Mazzuco, Tania Longo, Micko, Alexander, Bourcigaux, Nathalie, Neggers, Sebastian, Newell-Price, John, Perez-Berida, Belén, Ortiz, Leon D, Ragnarsson, Oskar, Ragonese, Marta, Reincke, Martin, Sadoul, Jean-Loui, Shimatsu, Akira, Syro, Luis V, Taillandier, Luc, Toth, Miklo, Usui, Takeshi, Valkusz, Zauzsanna, Vila, Greisa, Whitelaw, Ben, and Zatelli, Maria Chiara
- Subjects
Male ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Medizin ,pituitary carcinoma ,Pituitary neoplasm ,Neurosurgical Procedure ,Neurosurgical Procedures ,0302 clinical medicine ,Endocrinology ,Pituitary tumour, aggressive pituitary tumour, pituitary carcinoma, temozolomide ,Surveys and Questionnaires ,Antineoplastic Combined Chemotherapy Protocols ,Surveys and Questionnaire ,Pituitary Neoplasm ,Adenoma ,Adolescent ,Adult ,Aged ,Antineoplastic Agents, Alkylating ,Bevacizumab ,Capecitabine ,Carcinoma ,Carmustine ,Child ,Child, Preschool ,DNA Modification Methylases ,DNA Repair Enzymes ,Dacarbazine ,Europe ,Female ,Humans ,Ki-67 Antigen ,Middle Aged ,Neoplasm Invasiveness ,Pituitary Neoplasms ,Societies, Medical ,Temozolomide ,Thalidomide ,Tumor Suppressor Proteins ,Young Adult ,Cranial Irradiation ,DNA Repair Enzyme ,General Medicine ,Alkylating ,aggressive pituitary tumour ,3. Good health ,Diabetes and Metabolism ,030220 oncology & carcinogenesis ,Human ,medicine.drug ,medicine.medical_specialty ,030209 endocrinology & metabolism ,Antineoplastic Agents ,03 medical and health sciences ,Internal medicine ,Medical ,DNA Modification Methylase ,medicine ,Preschool ,Neoplasm Invasivene ,Tumor Suppressor Protein ,Chemotherapy ,Antineoplastic Combined Chemotherapy Protocol ,Pituitary tumour ,business.industry ,medicine.disease ,Concomitant ,business ,Societies ,Progressive disease - 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 (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.
- Published
- 2018