Approach to the Treatment of a Patient with an Aggressive Pituitary Tumor.

Abstract

A small subset of pituitary adenomas grows despite maximal treatment with standard therapies; namely, surgery and radiotherapy. These aggressive tumors demonstrate 2 patterns of growth: they may be locally aggressive or metastasize distantly, either hematogenously or through the spinal fluid. Further surgery and radiotherapy may be helpful for palliation of symptoms, but they are rarely definitive in the management of these malignant tumors. The only chemotherapy with established activity in the treatment of pituitary tumors is the alkylating agent temozolomide. At most, 50% of patients exhibit an objective response to temozolomide and the median time to progression is short; thus, there remains a significant unmet need for effective treatments within this patient population. Several targeted agents have reported activity in this tumor type-including small molecule inhibitors, checkpoint inhibitors, and other biologics-but remain investigational at this time.

• Authors: Andrew L Lin, Mark T A Donoghue, Sharon L Wardlaw, T Jonathan Yang, Lisa Bodei, Viviane Tabar, Eliza B Geer
• Journal: The Journal of clinical endocrinology and metabolism (J Clin Endocrinol Metab) Vol. 105 Issue 12 (12 01 2020) ISSN: 1945-7197 [Electronic] United States
• PMID: 32930787 (Publication Type: Case Reports, Journal Article, Research Support, N.I.H., Extramural, Review)
• Copyright: © The Author(s) 2020. Published by Oxford University Press on behalf of the Endocrine Society. All rights reserved. For permissions, please e-mail: [email protected].

Topics

• Adenoma (pathology, therapy)
• Chemoradiotherapy, Adjuvant
• Drug Resistance, Neoplasm
• Female
• Humans
• Middle Aged
• Neoplasm Invasiveness
• Neoplasm Recurrence, Local (therapy)
• Neurosurgical Procedures
• Pituitary Neoplasms (pathology, therapy)
• Treatment Outcome