PO07TREATMENT OF AGGRESSIVE PITUITARY TUMOURS WITH TEMOZOLOMIDE

Abstract

INTRODUCTION: The management of aggressive pituitary tumours is challenging and conventional treatments are unable to provide long-term tumour control. In the salvage setting, Temozolomide (TMZ) has shown promising results both in reducing tumour size and hormone hypersecretion. METHOD: We present two patients, case 1 with a rapidly growing atypical prolactinoma and case 2 with a clinically non-functioning pituitary carcinoma with a spinal metastasis, treated with TMZ (200mg/m2, d1-d5/28 days, 12 and 6 cycles respectively) at tumour progression after multiple treatment approaches. RESULTS: TMZ provided good control of disease in both cases in parallel with reduced serum prolactin in case 1. Treatment was well tolerated with minimal toxicity.Tumourrecurrencewasobserved36months after treatment termination in case 1 and the patient received stereotactic radiosurgery. Eight months after the termination of TMZ, case 2 is asymptomatic with controlled disease. CONCLUSION: TMZ was effective in the management of two aggressive pituitary tumours that failed to respond to conventional treatments. Prospective controlled studies are needed to define optimal treatment dose and duration and uniform criteria to select patients who will benefit from TMZ.