Efficacy and safety of temozolomide in the treatment of aggressive pituitary neuroendocrine tumours in Spain

Current guidelines recommend temozolomide as the first-line chemotherapy for aggressive pituitary neuroendocrine tumours. However, no clinical trials have been conducted to date and clinical experience is quite limited. We retrospectively analyzed 28 patients (9 women and 19 men), aged 46.6 + 16.9,...

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Autores: Lamas, C, Cámara, R, Fajardo, C, Remon-Ruiz, P, Biagetti, B, Guerrero-Pérez, F, Araujo-Castro, M, Mora, M, Hanzu, F, Iglesias, P, García-Centeno, R, Soto, A
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2023
País:España
Institución:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p16088
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/16088
Access Level:acceso abierto
Palabra clave:temozolomide
pituitary neuroendocrine tumor
pituitary carcinoma
aggressive pituitary tumor
radiotherapy
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spelling Efficacy and safety of temozolomide in the treatment of aggressive pituitary neuroendocrine tumours in SpainLamas, CCámara, RFajardo, CRemon-Ruiz, PBiagetti, BGuerrero-Pérez, FAraujo-Castro, MMora, MHanzu, FIglesias, PGarcía-Centeno, RSoto, Atemozolomidepituitary neuroendocrine tumorpituitary carcinomaaggressive pituitary tumorradiotherapyCurrent guidelines recommend temozolomide as the first-line chemotherapy for aggressive pituitary neuroendocrine tumours. However, no clinical trials have been conducted to date and clinical experience is quite limited. We retrospectively analyzed 28 patients (9 women and 19 men), aged 46.6 + 16.9, with aggressive pituitary tumours (4 pituitary carcinomas and 24 aggressive adenomas) treated with temozolomide in 10 Spanish pituitary reference centres. Four patients had Cushing's disease, 9 prolactinomas and 15 clinically non-functioning pituitary tumours (seven silent corticotroph, three silent somatotroph, one silent lactotroph, one silent gondotroph and three null-cell tumours). Median size at diagnosis was 10.5 cm3 (IQR 4.7-22.5), with cavernous sinus invasion in 88% and no metastases. Pre-temozolomide treatment, these data were 5.2 cm3 (IQR 1.9-12.3), 89.3% and 14.3% (2 intracranial and 2 spinal metastases). All patients had undergone surgery (1-5 surgeries), 25 (89.3%) had received radiotherapy (7 of them reirradiated) and 13(46.4%) had received cabergoline. One patient interrupted temozolomide prematurely. The remaining 27 patients received a median of 13 cycles (range 3-66) of 5 days every 28 days, with a mean initial dose of 265 +/- 73 mg when administered alone and of 133 +/- 15 mg when co-administered with radiotherapy. Eight patients (29.6%) had a significant reduction (>30%) in tumour volume and 14 (51.9%) attained tumour stabilization. After a median follow-up of 29 months (IQR 10-55), 8 out of these 22 showed disease progression. A longer progression-free survival was found in the five patients who received concomitant radiotherapy. Seven patients (25%) died (all of them because of tumour progression or complications of treatments) at 77 months (IQR 42-136) after diagnosis and 29 months (IQR 16-55) after the first dose of temozolomide. Adverse effects occurred in 18 patients (14 mild and 4 moderate or severe). In conclusion, temozolomide is an effective medical treatment for aggressive pitNET and pituitary carcinomas but is sometimes followed by tumour progression. Co-administration with radiotherapy may increase progression-free survival.FRONTIERS MEDIA SA2023info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fisabio.portalinvestigacion.com/publicaciones/16088Frontiers in EndocrinologyISSN: 16642392reponame:r-FISABIO. Repositorio Institucional de Producción Científicainstname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)Inglésinfo:eu-repo/semantics/openAccessoai:fisabio.fundanetsuite.com:p160882026-06-11T12:45:17Z
dc.title.none.fl_str_mv Efficacy and safety of temozolomide in the treatment of aggressive pituitary neuroendocrine tumours in Spain
title Efficacy and safety of temozolomide in the treatment of aggressive pituitary neuroendocrine tumours in Spain
spellingShingle Efficacy and safety of temozolomide in the treatment of aggressive pituitary neuroendocrine tumours in Spain
Lamas, C
temozolomide
pituitary neuroendocrine tumor
pituitary carcinoma
aggressive pituitary tumor
radiotherapy
title_short Efficacy and safety of temozolomide in the treatment of aggressive pituitary neuroendocrine tumours in Spain
title_full Efficacy and safety of temozolomide in the treatment of aggressive pituitary neuroendocrine tumours in Spain
title_fullStr Efficacy and safety of temozolomide in the treatment of aggressive pituitary neuroendocrine tumours in Spain
title_full_unstemmed Efficacy and safety of temozolomide in the treatment of aggressive pituitary neuroendocrine tumours in Spain
title_sort Efficacy and safety of temozolomide in the treatment of aggressive pituitary neuroendocrine tumours in Spain
dc.creator.none.fl_str_mv Lamas, C
Cámara, R
Fajardo, C
Remon-Ruiz, P
Biagetti, B
Guerrero-Pérez, F
Araujo-Castro, M
Mora, M
Hanzu, F
Iglesias, P
García-Centeno, R
Soto, A
author Lamas, C
author_facet Lamas, C
Cámara, R
Fajardo, C
Remon-Ruiz, P
Biagetti, B
Guerrero-Pérez, F
Araujo-Castro, M
Mora, M
Hanzu, F
Iglesias, P
García-Centeno, R
Soto, A
author_role author
author2 Cámara, R
Fajardo, C
Remon-Ruiz, P
Biagetti, B
Guerrero-Pérez, F
Araujo-Castro, M
Mora, M
Hanzu, F
Iglesias, P
García-Centeno, R
Soto, A
author2_role author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv temozolomide
pituitary neuroendocrine tumor
pituitary carcinoma
aggressive pituitary tumor
radiotherapy
topic temozolomide
pituitary neuroendocrine tumor
pituitary carcinoma
aggressive pituitary tumor
radiotherapy
description Current guidelines recommend temozolomide as the first-line chemotherapy for aggressive pituitary neuroendocrine tumours. However, no clinical trials have been conducted to date and clinical experience is quite limited. We retrospectively analyzed 28 patients (9 women and 19 men), aged 46.6 + 16.9, with aggressive pituitary tumours (4 pituitary carcinomas and 24 aggressive adenomas) treated with temozolomide in 10 Spanish pituitary reference centres. Four patients had Cushing's disease, 9 prolactinomas and 15 clinically non-functioning pituitary tumours (seven silent corticotroph, three silent somatotroph, one silent lactotroph, one silent gondotroph and three null-cell tumours). Median size at diagnosis was 10.5 cm3 (IQR 4.7-22.5), with cavernous sinus invasion in 88% and no metastases. Pre-temozolomide treatment, these data were 5.2 cm3 (IQR 1.9-12.3), 89.3% and 14.3% (2 intracranial and 2 spinal metastases). All patients had undergone surgery (1-5 surgeries), 25 (89.3%) had received radiotherapy (7 of them reirradiated) and 13(46.4%) had received cabergoline. One patient interrupted temozolomide prematurely. The remaining 27 patients received a median of 13 cycles (range 3-66) of 5 days every 28 days, with a mean initial dose of 265 +/- 73 mg when administered alone and of 133 +/- 15 mg when co-administered with radiotherapy. Eight patients (29.6%) had a significant reduction (>30%) in tumour volume and 14 (51.9%) attained tumour stabilization. After a median follow-up of 29 months (IQR 10-55), 8 out of these 22 showed disease progression. A longer progression-free survival was found in the five patients who received concomitant radiotherapy. Seven patients (25%) died (all of them because of tumour progression or complications of treatments) at 77 months (IQR 42-136) after diagnosis and 29 months (IQR 16-55) after the first dose of temozolomide. Adverse effects occurred in 18 patients (14 mild and 4 moderate or severe). In conclusion, temozolomide is an effective medical treatment for aggressive pitNET and pituitary carcinomas but is sometimes followed by tumour progression. Co-administration with radiotherapy may increase progression-free survival.
publishDate 2023
dc.date.none.fl_str_mv 2023
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fisabio.portalinvestigacion.com/publicaciones/16088
url https://fisabio.portalinvestigacion.com/publicaciones/16088
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv FRONTIERS MEDIA SA
publisher.none.fl_str_mv FRONTIERS MEDIA SA
dc.source.none.fl_str_mv Frontiers in Endocrinology
ISSN: 16642392
reponame:r-FISABIO. Repositorio Institucional de Producción Científica
instname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
instname_str Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
reponame_str r-FISABIO. Repositorio Institucional de Producción Científica
collection r-FISABIO. Repositorio Institucional de Producción Científica
repository.name.fl_str_mv
repository.mail.fl_str_mv
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