ECE2023 Poster Presentations Late-Breaking (40 abstracts)
Characterization of RNA expression and clinical outcomes in patients with aggresive pituitary tumors treated with temozolomide
Eva Venegas Moreno 1,1 , Pablo Remon 1 , Elena Dios-Fuentes 1 , Ana Piñar Gutiérrez 1 , Juan Manuel Canelo 1,1 , Rosario Oliva 2 , Miriam Alonso-Garcia 3 , Eugenio Cardenas 4 , Ariel Kaen 4 , Miguel E. G-Garcia 5 , David Cano Gonzales 1 , Raul M. Luque 5,5 & Alfonso Soto-Moreno 1
1Unidad de Gestión Clínica de Endocrinología y Nutrición. Institute of Biomedicine of Seville (IBIS), Virgen del Rocio Hospital/CSIC/University of Seville, Seville, Seville, Spain; 2UGC Endocrinología y Nutrición, Virgen Macarena, Seville, Spain; 3UGC Oncología Medica, Virgen del Rocio, Seville, Spain; 4UGC Neurocirugía, HU Virgen del Rocio, Seville, Spain; 5OncObesidad y Metabolismo’ del Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Cordoba
Methods: Descriptive retrospective study of the clinical outcomes and RNA expression in aggressive pituitary tumors treated with temozolomide. RNA expression was studied in tumor samples normalized to housekeeping genes including GH, POMC, PRL, αsub, FSH, LH, TSH, sst1, sst2, sst3, sst5, sst5b, sst5c, DR1, DR2T, DR2L, DR4, DR5, Ghrelin, In1-Ghrelin, GOAT, GHRR1b, AVPR1b, GHRH-R, GnRH-R, Ki-67, PTTG1, CRHR1.
Results: Ten patients were treated. 30% (3) prolactinoma, 30% (3) Cushing’s disease, 40% (4) NFPT. 30% (3) pituitary carcinomas. Median presentation size was 32 [30-37] mm, historical maximum size 33 [30-37] mm. At presentation, 80% (8) had invasion of the cavernous sinus, and 90% had supra-chiasmatic invasion. 50% (5) ACTH, 10% (1) null cell, 10% (1) GH, 20% (2) PRL and isolated GH, and 10% (1) PRL. Ki-67 greater than 3% in 80% (8), Ki-67>10% in 40% (4). The median number of previous interventions was 2 [2-3]. 60% (6) had received previous radiation therapy, while the rest received it concurrently, with 40% (4) receiving it via the STUPP protocol. The number of cycles received was 17 [6-27]. The RNA expression of Ki67 and PTTG1 was found to be elevated in pituitary carcinomas. The expression of Ghrelin was found to be greatly increased in carcinomas and aggressive tumors, with patients who died having higher levels than survivors. The median maximum size prior to TMZ was 23 [19-30] mm, and at 6 months of treatment, the median maximum size was 17.5 [14-23] mm. A partial response was observed according to RECIST in 40% (4) of cases at 6 months, with one patient achieving partial response criteria after more than 6 months. The median time to maximum response was 0.48 [0.38-1.29] years. Progression was observed in 40% (4) of cases, with a median time to progression from the start of TMZ of 1.61 [1.11-2.32] years. Currently, 50% (5) of patients are not on TMZ treatment, 30% (3) due to progression and complementary treatments, and 10% (1) due to patient relocation. No serious adverse effects were observed, but asthenia was observed in 40% (4) of patients.
Conclusions: The treatment with temozolomide is safe in aggressive pituitary tumors and allows for achieving an initial response and medium-term stability. The expression of certain RNAs (Ghrelin, PTTG1) may allow for estimating long-term aggressiveness risk and mortality.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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