Temozolomide Nonresponsiveness in Aggressive Prolactinomas and Carcinomas: Management and Outcomes.
Temozolomide Nonresponsiveness in Aggressive Prolactinomas and Carcinomas: Management and Outcomes.
复制标题
DOI：
10.1210/jendso/bvab190
复制
发表时间：
2022-02-01
影响因子：
4.1
通讯作者：
Dutta P
中科院分区：
文献类型：
--
作者：
Das L;Rai A;Salunke P;Ahuja CK;Sood A;Radotra BD;Sood R;Korbonits M;Dutta P
替莫唑胺(TMZ)被认可为侵袭性或恶性垂体腺瘤的首选治疗药物。在这里，我们描述了一例侵袭性催乳素瘤，它对TMZ具有耐药性。我们对类似的无反应性、侵袭性催乳素瘤进行了文献回顾。一位40岁的女性患者患有巨大的催乳素瘤，需要卡麦角林、经蝶窦手术和放射治疗才能使催乳素恢复到接近正常的水平，显然没有肿瘤残留。一年后，由于复发性肿瘤延伸至颞下窝，她出现多发性颅神经受累。她接受了经额手术，第二次放射治疗，并开始使用TMZ。尽管替莫唑胺治疗了8个周期(200 mg/m2，5/28天一周期)，但她仍有进展性疾病，并最终死于这种疾病。在PubMed/MEDLINE、Google Scholar和以前的综述文章中搜索关于曾接受TMZ治疗的侵袭性催乳素瘤患者的手稿。对进展性疾病患者的人口学数据、治疗持续时间和治疗结果进行分析。我们在文献中确定了94例接受TMZ治疗的侵袭性/恶性催乳素瘤患者。尽管存在TMZ，但仍有进展性疾病36例(38%)。在这些患者中男性占优势(65%)，40%的人患有侵袭性催乳素瘤，其余的人患有癌症。患者接受TMZ治疗的中位数为8个周期(四分位数范围为3.5-11.5)。O6-甲基鸟嘌呤-DNA-甲基转移酶(MGMT)免疫组织化学染色阴性者占35%。报告发表时的总死亡率为40%，病程从2年到20年不等。侵袭性/恶性催乳素瘤对TMZ的耐药性具有挑战性。进展性疾病的最佳TMZ治疗需要使用较新的药物。
Temozolomide (TMZ) is endorsed as the treatment of choice in aggressive or malignant pituitary adenomas. Herein we describe a case of an aggressive prolactinoma that was resistant to TMZ. We performed a literature review of similar nonresponsive, aggressive prolactinomas. A 40-year-old woman presented with a giant prolactinoma that required cabergoline, transsphenoidal surgery, and radiotherapy to achieve near-normal prolactin and apparently no residual tumor. A year later, she presented with multiple cranial nerve involvement due to a recurrent tumor extending to the infratemporal fossa. She underwent transfrontal surgery, second radiotherapy, and was started on TMZ. Despite 8 cycles of temozolomide (200 mg/m2, 5/28-day cycle), she had progressive disease and ultimately succumbed to the disease. PubMed/MEDLINE, Google Scholar, and prior review articles were searched for manuscripts about patients with aggressive prolactinomas who had been treated with TMZ. Data on demography, duration of therapy, and management outcomes were analyzed in those with progressive disease. We identified 94 cases of patients with aggressive/malignant prolactinomas in the literature who had received TMZ. Progressive disease despite TMZ was present in 36 cases (38%). There was a male preponderance (65%) among these and 40% had aggressive prolactinomas, whereas the rest had carcinomas. Patients received a median of 8 cycles (interquartile range, 3.5-11.5) of TMZ. O6‐methylguanine‐DNA‐methyltransferase (MGMT) immunostaining was negative in 35%. Overall mortality at the time of publication was 40%, at a duration varying from 2 to 20 years from diagnosis. TMZ resistance in aggressive/malignant prolactinomas is challenging. Progressive disease on optimal TMZ treatment entails the use of newer agents.
登录
查看更多内容
影响因子：
5.2
作者：
Das L;Gupta N;Dutta P;Walia R;Vaiphei K;Rai A;Radotra BD;Gupta K;Sreedharanunni S;Ahuja CK;Bhansali A;Tripathi M;Sood R;Dhandapani S
通讯作者：
Dhandapani S
影响因子：
3.8
作者：
Ceccato F;Lizzul L;Voltan G;Barbot M;Scaroni C
通讯作者：
Scaroni C
雌激素受体拮抗剂对 MMQ 垂体催乳素瘤细胞系增殖、催乳素分泌和生长因子表达的影响。
影响因子：
2
作者：
Leng, Lige;Zhang, Yazhuo
通讯作者：
Zhang, Yazhuo
影响因子：
5.5
作者：
Kovacs, Gabor L.;Goth, Miklos;Korbonits, Marta
通讯作者：
Korbonits, Marta
影响因子：
3.8
作者：
Lasolle, Helene;Ilie, Mirela Diana;Raverot, Gerald
通讯作者：
Raverot, Gerald