title: Temozolomide Therapy for Aggressive Pituitary Tumors: Results in a Small Series of Patients from Argentina.
abstract: We evaluated results of temozolomide (TMZ) therapy in six patients, aged 34-78 years, presenting aggressive pituitary tumors. In all the patients tested O(6)-methylguanine-DNA methyltransferase (MGMT) immunoexpression in surgical specimens was absent. Patients received temozolomide 140-320 mg/day for 5 days monthly for at least 3 months. In two patients minimum time for evaluation could not be reached because of death in a 76-year-old man with a malignant prolactinoma and of severe neutro-thrombopenia in a 47-year-old woman with nonfunctioning pituitary adenoma. In two patients (a 34-year-old acromegalic woman and a 39-year-old woman with Nelson's syndrome) no response was observed after 4 and 6 months, respectively, and the treatment was stopped. Conversely, two 52- and 42-year-old women with Cushing's disease had long-term total clinical and radiological remissions which persisted after stopping temozolomide. We conclude that TMZ therapy may be of variable efficacy depending on-until now-incompletely understood factors. Cooperative work on a greater number of cases of aggressive pituitary tumors should be crucial to establish the indications, doses, and duration of temozolomide administration.
authors.affiliation: Foundation of Endocrinology, 1425 Buenos Aires, Argentina.
authors.forename: Oscar D
authors.initials: OD
authors.lastname: Bruno
authors.affiliation: Foundation of Endocrinology, 1425 Buenos Aires, Argentina.
authors.forename: Lea
authors.initials: L
authors.lastname: Juárez-Allen
authors.affiliation: Pathology Laboratory, Hospital Italiano, 1199 Buenos Aires, Argentina.
authors.forename: Silvia B
authors.initials: SB
authors.lastname: Christiansen
authors.affiliation: Division of Endocrinology, Hospital de Clínicas, University of Buenos Aires, 1120 Buenos Aires, Argentina.
authors.forename: Marcos
authors.initials: M
authors.lastname: Manavela
authors.affiliation: Division of Endocrinology, Hospital de Clínicas, University of Buenos Aires, 1120 Buenos Aires, Argentina.
authors.forename: Karina
authors.initials: K
authors.lastname: Danilowicz
authors.affiliation: Division of Endocrinology, Hospital de Clínicas, University of Buenos Aires, 1120 Buenos Aires, Argentina.
authors.forename: Carlos
authors.initials: C
authors.lastname: Vigovich
authors.affiliation: Division of Endocrinology, Hospital de Clínicas, University of Buenos Aires, 1120 Buenos Aires, Argentina.
authors.forename: Reynaldo M
authors.initials: RM
authors.lastname: Gómez