Exp Clin Endocrinol Diabetes 2010; 118(10): 760-763
DOI: 10.1055/s-0030-1253419
Short Communication

© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

SOM230 (Pasireotide) and Temozolomide Achieve Sustained Control of Tumour Progression and ACTH Secretion in Pituitary Carcinoma with Widespread Metastases

H. Bode1 , M. Seiz2 , A. Lammert1 , M. A. Brockmann3 , W. Back4 , H.-P. Hammes1 , C. Thomé2
  • 1V. Medizinische Klinik, University Hospital Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Theodor-Kutzer-Ufer, Mannheim, Germany
  • 2Neurochirurgische Klinik, University Hospital Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Theodor-Kutzer-Ufer, Mannheim, Germany
  • 3Institut für Neuroradiologie, University Hospital Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Theodor-Kutzer-Ufer, Mannheim, Germany
  • 4Pathologisches Institut, University Hospital Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Theodor-Kutzer-Ufer, Mannheim, Germany
Further Information

Publication History

received 13.01.2010 first decision 25.02.2010

accepted 15.04.2010

Publication Date:
21 May 2010 (online)

Abstract

Pituitary carcinomas are rare and neurosurgically challenging lesions, as they commonly relapse after surgical removal. Their prognosis is dismal due to their limited response to radiotherapy and chemotherapy. In recent studies, temozolomide was administered in very few patients with partial effects. We report a patient with an ACTH-secreting pituitary carcinoma and widespread intracranial, spinal and systemic metastases despite repeated surgical treatment, bilateral adrenalectomy, medical treatment and radiotherapy. Additionally to chemotherapy with temozolomide, the patient received SOM230 as salvage therapy with an improvement of the patient's clinical status, and a reduction of ACTH levels. After 12 months of combination therapy a sustained tumor control was achieved and persisted upon monotherapy with SOM230 for more than 9 months thereafter. Thus, temozolomide in combination with SOM230 seems to be promising in patients with ACTH-secreting metastasized pituitary carcinoma.

References

  • 1 Ragel BT, Couldwell WT. Pituitary carcinoma: a review of the literature.  Neurosurg Focus. 2004;  16 Article7
  • 2 Sidibé EH. Pituitary carcinoma. Anatomic and clinical features of cases reported in literature.  Neurochirurgie. 2007;  53 284-288
  • 3 Kaltsas GA, Nomikos P, Kontogeorgos G. et al . CLINICAL REVIEW: Diagnosis and Management of Pituitary Carcinomas.  J Clin Endocrinol Metab. 2005;  90 3089-3099
  • 4 Gaffey TA, Scheithauer BW, Lloyd RV. et al . Corticotroph carcinoma of the pituitary: a clinicopathological study.  J Neurosurg. 2002;  96 352-360
  • 5 Pernicone PJ, Scheithauer BW, Sebo TJ. et al . Pituitary Carcinoma A Clinicopathologic Study of 15 Cases.  Cancer. 1997;  79 804-812
  • 6 Landman RE, Horwith M, Peterson RE. et al . Long-term survival with ACTH-secreting carcinoma of the pituitary: a case report and review of the literature.  J Clin Endocrinol Metab. 2002;  87 3084-3089
  • 7 Stupp R, Mason WP, van den Bent MJ. et al . Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma.  N Engl J Med. 2005;  352 978-996
  • 8 Fadul CE, Kominsky AL, Meyer LP. et al . Long-term response of pituitary carcinoma to temozolomide. Report of two cases.  J Neurosurg. 2006;  105 621-626
  • 9 Lim S, Shahinian H, Maya MM. et al . Temozolomide: a novel treatment for pituitary carcinoma.  Lancet Oncol. 2006;  7 518-520
  • 10 Hagen C, Schroeder HD, Hansen S. et al . Temozolomide treatment of a pituitary carcinoma and two pituitary macroadenomas resistant to conventional therapy.  Eur J Endocrinol. 2009;  161 631-637
  • 11 Moyes VJ, Alusi G, Sabin HI. et al . Treatment of Nelson's syndrome with temozolomide.  Eur J Endocrinol. 2009;  160 115-119
  • 12 Mohammed S, Kovacs K, Mason W. et al . xUse of temozolomide in aggressive pituitary tumors: case report. Mohammed S, Kovacs K, Mason W, Smyth H, Cusimano MD.  Neurosurgery. 2009;  64 E773–E774
  • 13 Guzel A, Tatli M, Senturk S. et al . Pituitary Carcinoma Presenting with Multiple Metastases: Case Report.  J Child Neurol. 2008;  23 1467-1471
  • 14 Boscaro M, Ludlam WH, Atkinson B. et al . Treatment of pituitary-dependent Cushing's disease with the multireceptor ligand somatostatin analog pasireotide (SOM230): a multicenter, phase II trial.  J Clin Endocrinol Metab. 2009;  94 115-122
  • 15 Batista DL, Zhang X, Gejman R. et al . The effects of SOM230 on cell proliferation and adrenocorticotropin secretion in human corticotroph pituitary adenomas.  J Clin Endocrinol Metab. 2006;  91 4482-4488
  • 16 Schmid HA. Pasireotide (SOM230): Development, mechanism of action and potential applications.  Mol Cell Endocrinol. 2008;  286 69-74
  • 17 Hofland LJ, van der Hoek J, Feelders R. et al . The multi-ligand somatostatin analogue SOM230 inhibits ACTH secretion by cultured human corticotroph adenomas via somatostatin receptor type 5.  2005;  152 645-654

Correspondence

Dr. H. Bode

V. Medizinische Klinik

Universitätsmedizin Mannheim

Theodor-Kutzer-Ufer 1–3

68167 Mannheim

Germany

Phone: +49/621/383 2317

Fax: +49/621/383 2159

Email: hinrich.bode@umm.de

    >