Early Recognition and Initiation of Temozolomide Chemotherapy for Refractory, Invasive Pituitary Macroprolactinoma with Long-Term Sustained Remission

被引:12
作者
Barkhoudarian, Garni [1 ]
Palejwala, Sheri K. [1 ]
Ogunbameru, Ronke [1 ]
Wei, Hua [1 ]
Eisenberg, Amalia [1 ]
Kelly, Daniel F. [1 ]
机构
[1] Providence St Johns Hlth Ctr, John Wayne Canc Inst, Pacific Neurosci Inst, Santa Monica, CA 90401 USA
关键词
Atypical prolactinoma; Chemotherapy; Dopamine agonist; Invasive adenoma; Pituitary adenoma; Refractory prolactinoma; Temozolomide; TUMORS; THERAPY; PROLACTINOMAS; CARCINOMAS; RESISTANT; EXPERIENCE; MANAGEMENT; ADENOMAS; SOCIETY;
D O I
10.1016/j.wneu.2018.07.082
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
OBJECTIVE: Invasive, medically refractory, and multiply recurrent pituitary adenomas pose a rare, but nevertheless significant, challenge for conventional management modalities. Temozolomide (TMZ) has been reported to be useful as an adjunctive treatment for some patients. We describe the efficacy of TMZ when used early in the management of invasive prolactinoma. CASE DESCRIPTION: A 56-year-old man presented with an invasive, refractory macroprolactinoma for which long-term dopamine agonists, stereotactic radiosurgery, and multiple transsphenoidal surgical resections had failed. He had experienced persistent hyperprolactinemia and tumor progression. Thus, TMZ was started. During the 11 cycles of TMZ therapy, the patient's prolactin level decreased from 696 ng/mL to 15.2 ng/mL, with a > 90% decrease in tumor size. Nearly 6 years after discontinuing chemotherapy, the patient remained in sustained remission (prolactin level, 3.1 ng/mL) requiring only 1.5 mg of cabergoline weekly, without radiographic or clinical evidence of tumor recurrence. CONCLUSIONS: We conclude that TMZ can be efficacious in the management of medically and surgically refractory, invasive atypical prolactinomas, resulting in normalization of the prolactin levels and control of the tumor size. We encourage the inclusion of TMZ in the management of refractory, recurrent, and invasive prolactinomas, as a fourth-line treatment strategy, after dopamine agonist treatment, transsphenoidal resection, and radiation therapy. We especially advocate the early use of TMZ for aggressive and otherwise refractory prolactinomas.
引用
收藏
页码:118 / 124
页数:7
相关论文
共 19 条
[1]   Temozolomide Treatment for Aggressive Pituitary Tumors: Correlation of Clinical Outcome with O6-Methylguanine Methyltransferase (MGMT) Promoter Methylation and Expression [J].
Bush, Zachary M. ;
Longtine, Janina A. ;
Cunningham, Tracy ;
Schiff, David ;
Jane, John A., Jr. ;
Vance, Mary Lee ;
Thorner, Michael O. ;
Laws, Edward R., Jr. ;
Lopes, M. Beatriz S. .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2010, 95 (11) :E280-E290
[2]   Guidelines of the Pituitary Society for the diagnosis and management of prolactinomas [J].
Casanueva, Felipe F. ;
Molitch, Mark E. ;
Schlechte, Janet A. ;
Abs, Roger ;
Bonert, Vivien ;
Bronstein, Marcello D. ;
Brue, Thierry ;
Cappabianca, Paolo ;
Colao, Annamaria ;
Fahlbusch, Rudolf ;
Fideleff, Hugo ;
Hadani, Moshe ;
Kelly, Paul ;
Kleinberg, David ;
Laws, Edward ;
Marek, Josef ;
Scanlon, Maurice ;
Sobrinho, Luis G. ;
Wass, John A. H. ;
Giustina, Andrea .
CLINICAL ENDOCRINOLOGY, 2006, 65 (02) :265-273
[3]   Long-term response of pituitary carcinoma to temozolomide - Report of two cases [J].
Fadul, Camilo E. ;
Kominsky, Andrew L. ;
Meyer, Louise P. ;
Kingman, Linda S. ;
Kinlaw, William B. ;
Rhodes, C. Harker ;
Eskey, Clifford J. ;
Simmons, Nathan E. .
JOURNAL OF NEUROSURGERY, 2006, 105 (04) :621-626
[4]   Temozolomide treatment of a pituitary carcinoma and two pituitary macroadenomas resistant to conventional therapy [J].
Hagen, C. ;
Schroeder, H. D. ;
Hansen, S. ;
Hagen, C. ;
Andersen, M. .
EUROPEAN JOURNAL OF ENDOCRINOLOGY, 2009, 161 (04) :631-637
[5]   DNA Mismatch Repair Protein (MSH6) Correlated With the Responses of Atypical Pituitary Adenomas and Pituitary Carcinomas to Temozolomide: The National Cooperative Study by the Japan Society for Hypothalamic and Pituitary Tumors [J].
Hirohata, Toshio ;
Asano, Kenichiro ;
Ogawa, Yoshikazu ;
Takano, Shingo ;
Amano, Kosaku ;
Isozaki, Osamu ;
Iwai, Yoshiyasu ;
Sakata, Kiyohiko ;
Fukuhara, Noriaki ;
Nishioka, Hiroshi ;
Yamada, Shozo ;
Fujio, Shingo ;
Arita, Kazunori ;
Takano, Koji ;
Tominaga, Atsushi ;
Hizuka, Naomi ;
Ikeda, Hidetoshi ;
Osamura, R. Yoshiyuki ;
Tahara, Shigeyuki ;
Ishii, Yudo ;
Kawamata, Takakazu ;
Shimatsu, Akira ;
Teramoto, Akira ;
Matsuno, Akira .
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM, 2013, 98 (03) :1130-1136
[6]   Temozolomide therapy in a man with an aggressive prolactin-secreting pituitary neoplasm: morphological findings [J].
Kovacs, Kalman ;
Horvath, Eva ;
Syro, Luis V. ;
Uribe, Humberto ;
Penagos, Luis C. ;
Ortiz, Leon D. ;
Fadul, Camilo E. .
HUMAN PATHOLOGY, 2007, 38 (01) :185-189
[7]   Salvage therapy with temozolomide in patients with aggressive or metastatic pituitary adenomas: experience in six cases [J].
Losa, Marco ;
Mazza, Elena ;
Terreni, Maria Rosa ;
McCormack, Ann ;
Gill, Anthony J. ;
Motta, Micaela ;
Cangi, Maria Giulia ;
Talarico, Anna ;
Mortini, Pietro ;
Reni, Michele .
EUROPEAN JOURNAL OF ENDOCRINOLOGY, 2010, 163 (06) :843-851
[8]   USE OF TEMOZOLOMIDE IN AGGRESSIVE PITUITARY TUMORS: CASE REPORT [J].
Mohammed, Safraz ;
Kovacs, Kalman ;
Mason, Warren ;
Smyth, Harley ;
Cusimano, Michael D. .
NEUROSURGERY, 2009, 64 (04) :773-774
[9]   The epidemiology of endocrine tumours [J].
Monson, JP .
ENDOCRINE-RELATED CANCER, 2000, 7 (01) :29-36
[10]   Giant prolactinomas: the therapeutic approach [J].
Moraes, Aline B. ;
dos Santos Silva, Cintia Marques ;
Vieira Neto, Leonardo ;
Gadelha, Monica R. .
CLINICAL ENDOCRINOLOGY, 2013, 79 (04) :447-456