ECE2015 Guided Posters Endocrine tumours and neoplasia – General (7 abstracts)
Temozolomide treatment for pituitary aggressive tumours and pituitary carcinomas: initial results and long-term follow-up of a cohort of 32 cases
Hélène Lasolle 1 , Fréderic Castinetti 2 , Christine Cortet 3 , Lucie Cloix 4 , Marie Batisse-Lignier 10 , Fabrice Bonnet 15 , Nathalie Bourcigaux 11 , Olivier Chabre 12 , Philippe Chanson 17 , Brigitte Delemer 6 , Christine Lebrun-Frenay 7 , Cyril Garcia 13 , Yves Reznik 16 , Franck Schillo 9 , Luc Taillandier 14 , Dominique Maiter 8 , Jean-Louis Sadoul 7 , Philipe Caron 5 & Gérald Raverot 1
1Hospices civils de Lyon, Lyon, France; 2CHU de Marseille, Hôpital de la Timone, Marseille, France; 3CHU de Lille, Hôpital Claude Huriez, Lille, France; 4CHU de Tours, Hôpital Bretonneau, Tours, France; 5CHU de Toulouse, Hôpital Larrey, Toulouse, France; 6CHU de Reims, Hôpital Robert Debré, Reims, France; 7CHU de Nice, Hôpital de L’Archet, Nice, France; 8Université catholique de Louvain, Clinique Universitaire Saint Luc, Bruxelles, Belgium; 9CHU de Besançon, Hôpital Jean Minjoz, Besançon, France; 10CHU de Clermont-Ferrand, Hôpital Gabriel-Montpied, Clermont-Ferrand, France; 11APHP, Hôpital Saint Antoine, Paris, France; 12CHU de Grenoble, Grenoble, France; 13Hôpital Bégin, Paris, France; 14CHU de Poitiers, Poitiers, France; 15CHU de Rennes, Rennes, France; 16CHU de Caen, Caen, France; 17APHP, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France.
Context: Successful used of temozolomide (TMZ) treatment has been described in 40–50% of aggressive pituitary tumour (PT) or rare pituitary carcinoma. These results are based on 50 case-reports and small series, data on long-term follow-up being rare.
Objectives: To describe initial results and long-term follow-up of a large French cohort of patients presenting PT treated with temozolomide.
Design: Members of the French Society of Endocrinology were surveyed regarding the clinical characteristics of PT treated with TMZ. Hormone and tumour responses to treatment were evaluated after three to six cycles and at the last follow-up.
Patients: 32 patients (M=20) from 16 centers, 19 aggressive PT, 13 carcinomas including 16 ACTH, 12 PRL, and four GH-secreting tumours were followed 21.7±18 months after the treatment.
Results: Age at diagnosis was 42.8±19 years. All patients underwent radiotherapy, 28/32 pituitary surgeries (1–5). TMZ, 150–200 mg/m2 5days a month, was initiated (with radiotherapy in five cases) 8.2±7.5 years after diagnosis for 8.4 cycles (3–24). Tolerance was good (thrombopenia, n=3 and pancytopenia, n=2). Overall, early response was noted in 18/32 (56.3%) with similar rate between ACTH (56%) and PRL (58%), lower for GH (50%) and higher rate in adenomas (63%) than carcinomas (46%). End of treatment response was maintained in only 13/18 patients after 10.2±5.6 cycles. No initial resistant cases responded to TMZ after 6.6±4.4 cycles. Among the 18 responders, four were in remission (three ACTH) after 30±13 months, regrowth was noted in ten patients 18±18 months after TMZ administration. Second try of TMZ failed in all cases (n=7). 8/14 resistant cases deceased compare to 2/18 initially sensitive cases. In case of TMZ failure, carboplatin-VP16, cisplatin±adriblastine, everolimus have been tested without significant effect.
Conclusion: Initial PT response to TMZ is frequent but long-term control or remission is rare. This survey underlined lack of homogeneous therapeutic protocol and the need for guideline.
Volume 37
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Endocrine Abstracts
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