Aggressive pituitary tumours: the role of temozolomide and the assessment of MGMT status.
Reads0
Chats0
TLDR
Eur J Clin Invest 2011; 41 (10): 1133–1148.Abstract:
Eur J Clin Invest 2011; 41 (10): 1133–1148
Abstract
Background Aggressive pituitary tumours are associated with substantial morbidity and mortality. Treatment options are often limited, and chemotherapy has been reserved as salvage therapy although historically results have often been disappointing. However, temozolomide, an oral alkylating agent, has recently demonstrated significant activity against these tumours. A DNA repair protein, 06-methylguanine-DNA methyltransferase (MGMT) has been suggested as a biomarker to predict response to temozolomide in pituitary tumours.
Materials and methods This paper will review the current literature on temozolomide and pituitary tumours and discuss the recent controversy surrounding the value of determining the MGMT status in this tumour group. A PubMed search was performed to retrieve articles, using the terms ‘pituitary tumour’ and ‘temozolomide’.
Results Overall, 24/40 (60%) of the published cases demonstrated a response to temozolomide therapy. The highest response rates were seen amongst prolactinomas (73%) and ACTH-secreting tumours (60%), whilst nonfunctioning pituitary tumours exhibit lower response rates (40%). Responsivity is typically evident in the first 3 months of therapy and may be dramatic and sustained. Low MGMT expression, as determined by immunohistochemistry, is associated with a high response rate (76%), whilst high MGMT expression has not been associated with responses. MGMT promoter methylation does not correlate with temozolomide response.
Conclusions Temozolomide is the first chemotherapeutic agent to show substantial response rates in aggressive pituitary tumours. MGMT immunohistochemistry, but not MGMT methylation analysis, shows promise as a predictive tool. Prospective clinical trials are now necessary to more accurately determine the efficacy of this agent in this patient group.read more
Citations
More filters
Journal ArticleDOI
A new prognostic clinicopathological classification of pituitary adenomas: a multicentric case–control study of 410 patients with 8 years post-operative follow-up
Jacqueline Trouillas,Jacqueline Trouillas,Pascal Roy,Nathalie Sturm,Emmanuelle Dantony,Christine Cortet-Rudelli,Gabriel Viennet,Jean-François Bonneville,Richard Assaker,Carole Auger,Carole Auger,Thierry Brue,Aurélie Cornelius,Henry Dufour,Emmanuel Jouanneau,Patrick François,Françoise Galland,François Mougel,François Chapuis,Laurent Villeneuve,Claude-Alain Maurage,Dominique Figarella-Branger,Gérald Raverot +22 more
TL;DR: A new, easy to use clinicopathological classification of pituitary endocrine tumours has demonstrated its prognostic worth by strongly predicting the probability of post-operative complete remission or tumour progression and so could help clinicians choose the best post-operation therapy.
Journal ArticleDOI
European Society of Endocrinology clinical practice guidelines for the management of aggressive pituitary tumours and carcinomas
Gérald Raverot,Pia Burman,Ann McCormack,Anthony P. Heaney,Stephan Petersenn,Vera Popovic,Jacqueline Trouillas,Olaf M. Dekkers +7 more
TL;DR: The guideline offers recommendations for patients who recurred after temozolomide treatment, for those who did not respond to temozoomide and for patients with systemic metastasis, which focused primarily on first- and second-line treatment in aggressive pituitary tumours and carcinomas.
Journal ArticleDOI
Aggressive pituitary adenomas—diagnosis and emerging treatments
TL;DR: The need to develop new biomarkers to facilitate the early detection of clinically aggressive pituitary adenomas is highlighted and emerging markers that hold promise for their identification are discussed.
Journal ArticleDOI
Treatment of aggressive pituitary tumours and carcinomas: results of a European Society of Endocrinology (ESE) survey 2016
Ann McCormack,Olaf M. Dekkers,Stephan Petersenn,Vera Popovic,Jacqueline Trouillas,Gérald Raverot,Pia Burman +6 more
TL;DR: This survey confirms that TMZ is established as first-line chemotherapeutic treatment of APT/PC and the limited long-term effect of TMZ and the poor efficacy of other drugs highlight the need to identify additional effective therapies.
Journal ArticleDOI
Aggressive Pituitary Tumors
TL;DR: The present review provides information regarding the epidemiology and clinical, histopathological and molecular features of aggressive pituitary tumors using recent employed definitions and highlights the need to identify more specific disease-related and prognostic markers and the necessity for central registration of these tumors.
References
More filters
Journal ArticleDOI
Radiotherapy plus Concomitant and Adjuvant Temozolomide for Glioblastoma
Roger Stupp,Warren P. Mason,Martin J. van den Bent,Michael Weller,Barbara Fisher,Martin J.B. Taphoorn,Karl Belanger,Alba A. Brandes,Christine Marosi,Ulrich Bogdahn,Jürgen Curschmann,Robert C. Janzer,Samuel K. Ludwin,Thierry Gorlia,Anouk Allgeier,Denis Lacombe,J. Gregory Cairncross,Elizabeth Eisenhauer,René O. Mirimanoff +18 more
TL;DR: The addition of temozolomide to radiotherapy for newly diagnosed glioblastoma resulted in a clinically meaningful and statistically significant survival benefit with minimal additional toxicity.
Journal ArticleDOI
MGMT Gene Silencing and Benefit from Temozolomide in Glioblastoma
Monika E. Hegi,Annie-Claire Diserens,Thierry Gorlia,Marie-France Hamou,Nicolas de Tribolet,Nicolas de Tribolet,Michael Weller,Johan M. Kros,Johannes A. Hainfellner,Warren P. Mason,Luigi Mariani,Jacoline E C Bromberg,Peter Hau,René O. Mirimanoff,J. Gregory Cairncross,Robert C. Janzer,Roger Stupp +16 more
TL;DR: Patients with glioblastoma containing a methylated MGMT promoter benefited from temozolomide, whereas those who did not have a methylation of theMGMT promoter did notHave such a benefit and were assigned to only radiotherapy.
Journal ArticleDOI
Inactivation of the DNA-Repair Gene MGMT and the Clinical Response of Gliomas to Alkylating Agents
Manel Esteller,Jesús García-Foncillas,Esther Andion,Steven N. Goodman,Oscar Fernandez Hidalgo,Vicente Vanaclocha,Stephen B. Baylin,James G. Herman +7 more
TL;DR: Methylation of the MGMT promoter in gliomas is a useful predictor of the responsiveness of the tumors to alkylating agents and an independent and stronger prognostic factor than age, stage, tumor grade, or performance status.
Journal Article
Inactivation of the DNA repair gene O6-methylguanine-DNA methyltransferase by promoter hypermethylation is a common event in primary human neoplasia
TL;DR: The presence of aberrant hypermethylation was associated with loss of MGMT protein, in contrast to retention of protein in the majority of tumors without aberrantHypermethylation, suggesting that epigenetic inactivation of MG MT plays an important role in primary human neoplasia.
Journal ArticleDOI
Randomized Phase III Study of Temozolomide Versus Dacarbazine in the Treatment of Patients With Advanced Metastatic Malignant Melanoma
Mark R. Middleton,Jean-Jacques Grob,Neil K. Aaronson,G. Fierlbeck,Wolfgang Tilgen,S. Seiter,M. E. Gore,Steinar Aamdal,Jonathan Cebon,Alan S. Coates,Brigitte Dréno,M. Henz,Dirk Schadendorf,Alexander Kapp,Jürgen Weiss,U. Fraass,P. Statkevich,Martin J. Muller,Nick Thatcher +18 more
TL;DR: Temozolomide demonstrates efficacy equal to that of DTIC and is an oral alternative for patients with advanced metastatic melanoma.
Related Papers (5)
Temozolomide Treatment in Aggressive Pituitary Tumors and Pituitary Carcinomas: A French Multicenter Experience
Gérald Raverot,Nathalie Sturm,Florence de Fraipont,M. Muller,Sylvie Salenave,Philippe Caron,Olivier Chabre,Philippe Chanson,Christine Cortet-Rudelli,Richard Assaker,Henry Dufour,Stephan Gaillard,Patrick François,Emmanuel Jouanneau,Jean-Guy Passagia,Michèle Bernier,Aurélie Cornelius,Dominique Figarella-Branger,Jacqueline Trouillas,Françoise Borson-Chazot,Thierry Brue +20 more