Temozolomide Therapy in Management of Refractory Pituitary Adenomas: A Case Series of 39 Patients
Authors' conclusion
TMZ demonstrates promising efficacy in eliciting tumor responses in patients with PRA. O6-methylguanine DNA methyltransferase and MutS homologs 6 have emerged as potential biomarkers for predicting treatment response. Furthermore, radiation with concurrent TMZ may significantly improve outcomes in patients with RPA.
Study context
- Population
- Patients with refractory pituitary adenomas (RPA) treated with temozolomide (TMZ) after trans-sphenoidal surgery or craniotomy, comprehensive medical center in China, 2014–2021; median age 42 years, 59% male
- Participants
- 39 patients
- Outcome
- Long-term treatment outcomes with TMZ (tumor response)
- Follow-up
- Median 34.4 months
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Best response to TMZ
- Complete response
- 2 patients
- Partial response
- 11 patients
- Stable disease
- 9
- Progressive disease
- 11
- Death
- 6 patients
Observational data: associations, not effects.
Further findings
Mean
| Outcome | CR, PR or SD | PD or death | Tumor size reduction (mm³) | P value |
|---|---|---|---|---|
| O6-methylguanine DNA methyltransferase (MGMT) levels by response | 24.2% | 58.1 | ||
| MutS homolog 6 (MSH6) levels by response | 64.2% | 36.9% | ||
| Tumor size reductionTMZ + radiotherapy vs TMZ alone | 178,837 | P < 0.001 |
- Tumor size reduction: greater reduction with concomitant TMZ and external beam radiotherapy
O6-methylguanine DNA methyltransferase (MGMT) levels by response
- Significantly lower in complete response (CR), partial response (PR) or SD than progressive disease (PD) or death
MutS homolog 6 (MSH6) levels by response
- Significantly higher in CR, PR or SD than PD or death
Original publication
Temozolomide Therapy in Management of Refractory Pituitary Adenomas: A Case Series of 39 Patients. Endocr Pract. Published 22 October 2024. doi:10.
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