Abstract | BACKGROUND AND IMPORTANCE: CLINICAL PRESENTATION: We present a case series of 4 patients with aggressive, adrenocorticotrophic hormone--producing pituitary tumors who had previously depleted all surgical, radiation, and hormonal therapies and were then treated with CAPTEM. Dramatic clinical improvements in neurological deficits and Cushing symptoms were evident in all patients after treatment was initiated. Confirmed by radiographic imaging, 2 of 4 patients demonstrated complete regression of disease, 1 patient had a 75% regression, and the fourth patient has ongoing stable disease for > 4.5 years at the time of this writing. Immunohistochemical analysis of patients' tumor samples showed low O-methyguanyl methyltransferase expression and adequate levels of mismatch repair enzymes (MLH-1, MSH-2, MSH-6, and PMS-2), which are important for the in vivo efficacy of CAPTEM. CONCLUSION: This is the first report of prolonged antitumor response to and radiographic complete remissions as a result of CAPTEM in patients with aggressive pituitary tumors who had exhausted all other therapies.
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Authors | Brad E Zacharia, Anthony P Gulati, Jeffrey N Bruce, Arthur S Carminucci, Sharon L Wardlaw, Markus Siegelin, Helen Remotti, Angela Lignelli, Robert L Fine |
Journal | Neurosurgery
(Neurosurgery)
Vol. 74
Issue 4
Pg. E447-55; discussion E455
(Apr 2014)
ISSN: 1524-4040 [Electronic] United States |
PMID | 24226425
(Publication Type: Case Reports, Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
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Chemical References |
- Deoxycytidine
- Capecitabine
- Dacarbazine
- Fluorouracil
- Temozolomide
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Topics |
- ACTH-Secreting Pituitary Adenoma
(drug therapy, pathology)
- Adenoma
(drug therapy, pathology)
- Adult
- Antineoplastic Combined Chemotherapy Protocols
(therapeutic use)
- Capecitabine
- Dacarbazine
(administration & dosage, analogs & derivatives)
- Deoxycytidine
(administration & dosage, analogs & derivatives)
- Female
- Fluorouracil
(administration & dosage, analogs & derivatives)
- Humans
- Immunohistochemistry
- Male
- Middle Aged
- Pituitary ACTH Hypersecretion
(drug therapy, etiology, pathology)
- Temozolomide
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