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Article dans une revue

Temozolomide treatment can improve overall survival in aggressive pituitary tumors and pituitary carcinomas

Helene Lasolle 1, 2 Christine Cortet 3, 4 Frederic Castinetti 5, 6 Lucie Cloix 7, 8 Philippe Caron 9 Brigitte Delemer 10, 11 Rachel Desailloud 12 Christel Jublanc 13 Christine Lebrun-Frenay 14, 15 Jean-Louis Sadoul 14, 16 Luc Taillandier 17 Marie Batisse-Lignier 18, 19 Fabrice Bonnet 20 Nathalie Bourcigaux 21 Damien Bresson 22 Olivier Chabre 23 Philippe Chanson 24, 25 Cyril Garcia 26 Magalie Haissaguerre 27, 28 Yves Reznik 29 Sophie Borot 30, 31 Chiara Villa 32, 33 Alexandre Vasiljevic 34 Stephan Gaillard 32 Emmanuel Jouanneau 1, 2 Guillaume Assie 35, 33 Gerald Raverot 34, 1
Abstract : Objectives: Only few retrospective studies have reported an efficacy rate of temozolomide (TMZ) in pituitary tumors (PT), all around 50%. However, the long-term survival of treated patients is rarely evaluated. We therefore aimed to describe the use of TMZ on PT in clinical practice and evaluate the long-term survival. Design: Multicenter retrospective study by members of the French Society of Endocrinology. Methods: Forty-three patients (14 women) treated with TMZ between 2006 and 2016 were included. Most tumors were corticotroph (n = 23) or lactotroph (n = 13), and 14 were carcinomas. Clinical/pathological characteristics of PT, as well as data from treatment evaluation and from the last follow-up were recorded. A partial response was considered as a decrease in the maximal tumor diameter by more than 30% and/or in the hormonal rate by more than 50% at the end of treatment. Results: The median treatment duration was 6.5 cycles (range 2-24), using a standard regimen for most and combined radiotherapy for six. Twenty-two patients (51.2%) were considered as responders. Silent tumor at diagnosis was associated with a poor response. The median follow-up after the end of treatment was 16 months (0-72). Overall survival was significantly higher among responders (P = 0.002); however, ten patients relapsed 5 months (0-57) after the end of TMZ treatment, five in whom TMZ was reinitiated without success. Discussion: Patients in our series showed a 51.2% response rate to TMZ, with an improved survival among responders despite frequent relapses. Our study highlights the high variability and lack of standardization of treatment protocols.
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https://hal-u-picardie.archives-ouvertes.fr/hal-03555800
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Soumis le : jeudi 3 février 2022 - 18:26:30
Dernière modification le : vendredi 20 mai 2022 - 11:06:36

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Helene Lasolle, Christine Cortet, Frederic Castinetti, Lucie Cloix, Philippe Caron, et al.. Temozolomide treatment can improve overall survival in aggressive pituitary tumors and pituitary carcinomas. European Journal of Endocrinology, BioScientifica, 2017, 176 (6), pp.769-777. ⟨10.1530/EJE-16-0979⟩. ⟨hal-03555800⟩

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