Treatment of aggressive pituitary tumours and carcinomas: results of a European Society of Endocrinology (ESE) survey 2016

作者：Ann I. McCormack, Olaf M Dekkers, Stephan Petersenn, Vera M. POPOVIC, Jacqueline Trouillas, Gérald Raverot, Pia Burman, _ _, _ _, Alicia Hubalewska-Dydejezky, Guillaume Assié, Leon A. Bach, Marie Batisse‐Lignier, Katarina Berinder, Ismene Bilbao, Fabrice Bonnet, Damien Bresson, Oscar Domingo Bruno, Mariana Campderá, Philippe Jean Caron, Frédéric Castinetti, Filippo Ceccato, Olivier Chabre, Philippe Chanson, Emanuel Christ, Lucie Cloix, Christine Cortet, Lise Crinière, Guillem Cuatrecasas, Miguel Debono, Brigitte Delemer, Rachel Desailloud, Timo Deutschbein, Tina Dušek, Britt Edén Engström, Marco Faustini‐Fustini, Schillo Franck, Cyril Garcia, Yona Greenman, Susana Mallea Gil, Giovanna Mantovani, Mark Gurnell, Anthony P. Heaney, David B. Henley, Claire Emily Higham, E. W. Hoving, Charlotte Höybye, Atsuhiro Ichihara, Marie‐Lise Jaffrain‐Rea, Gudmundur Johannsson, Jens Otto Lunde Jørgensen, Christel Jublanc, Jan Komor, Márta Korbonits, Ivana Kralievic, Delphine Larrieu Ciron, Hélène Lasolle, Edward R. Laws, Marco Losa, Dominique M. Maiter, Claudio Marcocci, Olinda Castro Marques, Tânia Longo Mazzuco, Alexander S. G. Micko, Nathalie Bourcigaux, Sebastian J.C.M.M. Neggers, John D C Newell-Price, Belén Perez-Berida, León Darío Ortiz, Óskar Ragnarsson, Marta Ragonese, Martín Reincke, Jean‐Louis Sadoul, Akira Shimatsu, Luis V. Syro, Luc Taillandier, Miklós Tóth, Takeshi Usui, Zauzsanna Valkusz, Greisa Vila, Ben Whitelaw, Maria Chiara Zatelli · 发表于：European Journal of Endocrinology · 年份：2018 · DOI：10.1530/eje-17-0933 · 被引用次数：287 · 研究领域：Pituitary Gland Disorders and Treatments、Glioma Diagnosis and Treatment、Neuroendocrine Tumor Research Advances

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 re...