title: How effective is temozolomide for treating pituitary tumours and when should it be used?
abstract: Temozolomide (TMZ) has been shown as an effective treatment option in aggressive pituitary adenomas and carcinomas. This review analyses the published case series and demonstrates 42 % of patents show a radiological response and 27 % experience stable disease following TMZ. Prolactinomas and corticotroph tumours respond best to TMZ, showing approximately a 50 % response rate, with non-functioning tumours responding only half as frequently. Other factors that may predict the tumour's TMZ response include MGMT and MSH status, but neither is sufficiently robust to determine treatment decisions. TMZ has an accepted role in treating pituitary carcinoma and adenomas if radiation and surgery have failed to control tumour growth. To use TMZ on the basis of anticipated future aggression, as a primary therapy, or in preference to radiotherapy remains controversial.
authors: Department of Endocrinology, King's College Hospital, Denmark Hill, London, SE5 9RS, UK.
authors: Carmel
authors: C
authors: Halevy
authors: Department of Endocrinology, King's College Hospital, Denmark Hill, London, SE5 9RS, UK. benjamin.whitelaw@nhs.net.
authors: Benjamin C
authors: BC
authors: Whitelaw
mesh_terms: D018906:Antineoplastic Agents, Alkylating / Q000627:therapeutic use; D003606:Dacarbazine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D019853:O(6)-Methylguanine-DNA Methyltransferase / Q000378:metabolism; D010911:Pituitary Neoplasms / Q000188:drug therapy* / Q000201:enzymology; D015175:Prolactinoma / Q000188:drug therapy / Q000201:enzymology; D000077204:Temozolomide; D016896:Treatment Outcome
chemical_list: D018906:Antineoplastic Agents, Alkylating; D003606:Dacarbazine; D019853:O(6)-Methylguanine-DNA Methyltransferase; D000077204:Temozolomide
keywords: Aggressive; Methylguanine-DNA methyltransferase (MGMT); Pituitary; Review; Temozolomide