Temozolomide treatment can improve overall survival in aggressive pituitary tumors and pituitary carcinomas
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Frederic Castinetti
- Fonction : Auteur
- PersonId : 16755
- IdHAL : frederic-castinetti
- ORCID : 0000-0002-1808-8800
- IdRef : 113296061
Philippe Caron
- Fonction : Auteur
- PersonId : 182594
- IdHAL : philippe-caron
- ORCID : 0000-0003-2208-3436
Rachel Desailloud
- Fonction : Auteur
- PersonId : 767326
- ORCID : 0000-0001-9976-7938
- IdRef : 078643422
Christine Lebrun-Frenay
- Fonction : Auteur
- PersonId : 770285
- ORCID : 0000-0002-3713-2416
- IdRef : 074517929
Marie Batisse-Lignier
- Fonction : Auteur
Philippe Chanson
- Fonction : Auteur
- PersonId : 759641
- ORCID : 0000-0001-5096-5722
- IdRef : 029294452
Gerald Raverot
- Fonction : Auteur
- PersonId : 763607
- ORCID : 0000-0002-9517-338X
- IdRef : 073657905
Résumé
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.