| Temozolomide treatment in aggressive pituitary tumors and pituitary carcinomas: a French multicenter experience. | |
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MedLine Citation:
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PMID: 20660056 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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CONTEXT: To date only 18 patients with aggressive pituitary tumors or carcinomas treated with temozolomide have been reported. Increased expression of O6-methylguanine-DNA-methyltranferase (MGMT) has been suggested to predict resistance to temozolomide. OBJECTIVES: The objective of the study was to describe the antitumoral efficacy and toxicity of temozolomide in patients with aggressive pituitary tumors or carcinomas and evaluate the possible prognostic value of MGMT promoter methylation and protein expression. PATIENTS: Eight patients, five with pituitary carcinomas (three prolactin (PRL) and two ACTH) and three with aggressive pituitary tumors (one PRL and two ACTH), all treated with temozolomide administered orally for four to 24 cycles, were included in our French multicenter study. DESIGN: MGMT expression was assessed by immunohistochemistry and MGMT promoter methylation by pyrosequencing. RESULTS: Three of the eight patients (two ACTH adenomas and one PRL carcinoma) responded to temozolomide as demonstrated by significant tumor shrinkage and reduced hormone secretion. Three cycles of temozolomide were sufficient to identify treatment-responsive patients. Additional cycles did not improve treatment efficacy in those not responding, even when associated with carboplatin and vepeside. MGMT expression did not predict tumoral response to temozolomide because it was positive in one responder and negative in two nonresponders. Similarly, MGMT promoter methylation (three of seven tumors) did not predict clinical response. Toxicity remained mild in all patients. CONCLUSION: Temozolomide treatment may be an effective option for some aggressive pituitary tumors or carcinomas. Response to a trial of three cycles of treatment seems sufficient to identify responders and more reliable than patient MGMT status. |
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Authors:
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Gérald Raverot; Nathalie Sturm; Florence de Fraipont; Marie 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 Cornélius; Dominique Figarella-Branger; Jacqueline Trouillas; Françoise Borson-Chazot; Thierry Brue |
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Publication Detail:
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Type: Journal Article Date: 2010-07-21 |
Journal Detail:
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Title: The Journal of clinical endocrinology and metabolism Volume: 95 ISSN: 1945-7197 ISO Abbreviation: J. Clin. Endocrinol. Metab. Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-10-07 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0375362 Medline TA: J Clin Endocrinol Metab Country: United States |
Other Details:
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Languages: eng Pagination: 4592-9 Citation Subset: AIM; IM |
Affiliation:
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Institut National de la Santé et de la Recherche Médicale, Unité 842, Université de Lyon, Faculté de Médecine Lyon-Est, Lyon, France. gerald.raverot@chu-lyon.fr |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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