Abstract | BACKGROUND: MATERIALS AND METHODS: This paper will review the current literature on temozolomide and pituitary tumours and discuss the recent controversy surrounding the value of determining the MGMT status in this tumour group. A PubMed search was performed to retrieve articles, using the terms 'pituitary tumour' and ' temozolomide'. RESULTS: Overall, 24/40 (60%) of the published cases demonstrated a response to temozolomide therapy. The highest response rates were seen amongst prolactinomas (73%) and ACTH-secreting tumours (60%), whilst nonfunctioning pituitary tumours exhibit lower response rates (40%). Responsivity is typically evident in the first 3 months of therapy and may be dramatic and sustained. Low MGMT expression, as determined by immunohistochemistry, is associated with a high response rate (76%), whilst high MGMT expression has not been associated with responses. MGMT promoter methylation does not correlate with temozolomide response. CONCLUSIONS:
Temozolomide is the first chemotherapeutic agent to show substantial response rates in aggressive pituitary tumours. MGMT immunohistochemistry, but not MGMT methylation analysis, shows promise as a predictive tool. Prospective clinical trials are now necessary to more accurately determine the efficacy of this agent in this patient group.
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Authors | Ann I McCormack, John A H Wass, Ashley B Grossman |
Journal | European journal of clinical investigation
(Eur J Clin Invest)
Vol. 41
Issue 10
Pg. 1133-48
(Oct 2011)
ISSN: 1365-2362 [Electronic] England |
PMID | 21496012
(Publication Type: Journal Article)
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Copyright | © 2011 The Authors. European Journal of Clinical Investigation © 2011 Stichting European Society for Clinical Investigation Journal Foundation. |
Chemical References |
- Antineoplastic Agents, Alkylating
- Biomarkers, Tumor
- Dacarbazine
- O(6)-Methylguanine-DNA Methyltransferase
- Temozolomide
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Topics |
- Adenoma
(drug therapy, metabolism)
- Antineoplastic Agents, Alkylating
(therapeutic use)
- Biomarkers, Tumor
(metabolism)
- Carcinosarcoma
(drug therapy, metabolism)
- Dacarbazine
(analogs & derivatives, therapeutic use)
- Humans
- O(6)-Methylguanine-DNA Methyltransferase
(metabolism)
- Pituitary Neoplasms
(drug therapy, metabolism)
- Temozolomide
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