Pituitary

, Volume 15, Issue 1, pp 37–43

New targeted therapies in pituitary carcinoma resistant to temozolomide

  • Emmanuel Jouanneau
  • Anne Wierinckx
  • François Ducray
  • Véronique Favrel
  • Françoise Borson-Chazot
  • Jérôme Honnorat
  • Jacqueline Trouillas
  • Gérald Raverot
Article

Abstract

To evaluate the antitumoral efficacy of everolimus in pituitary carcinoma resistant to temozolomide, the correlation with mammalian target of rapamycin (mTOR) signaling in the tumor and to present recent advances and future treatments of pituitary carcinomas. Pituitary carcinomas are rare and largely unresponsive to current treatment options. Recent reports on the antitumoral efficacy of temozolomide in some such patients are encouraging, yet most patients appear to show resistance to its actions. As a potential alternative, the mTOR inhibitor, everolimus, has been shown to potently inhibit pituitary cell proliferation highlighting mTOR inhibition as a promising therapeutic approach for pituitary carcinomas. We described the tumoral effects of a combination therapy with everolimus (5 mg/day) and octreotide (30 mg/month) and the mTOR signalling expression in a patient with pituitary ACTH carcinoma, compared to 17 other ACTH adenomas. Clinical and biochemical evaluation were performed every month, and imaging after 3 month of treatment. mTOR signaling was assessed by microarray expression analysis of each of the 18 adenoma tissues. Combined therapy failed to control pituitary tumor growth and ACTH secretion. Slight activation of mTOR signaling was found in all ACTH tumors alongside important variations between tumors. Low antitumor efficacy shown by everolimus might be explained by the weak activation of mTOR pathway in ACTH tumors. Everolimus treatment was inefficient at controlling secretion and tumor growth of one ACTH pituitary carcinoma. More clinical cases, with mTOR signalling expression analysis of the tumor, must be published before any conclusions can be drawn.

Keywords

Pituitary carcinoma mTOR Everolimus Temozolomide Pituitary adenoma Silent ACTH tumor 

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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Emmanuel Jouanneau
    • 1
    • 2
    • 3
  • Anne Wierinckx
    • 1
    • 3
    • 4
  • François Ducray
    • 1
    • 2
    • 3
  • Véronique Favrel
    • 5
  • Françoise Borson-Chazot
    • 2
    • 3
  • Jérôme Honnorat
    • 1
    • 2
    • 3
  • Jacqueline Trouillas
    • 1
    • 2
    • 3
  • Gérald Raverot
    • 1
    • 2
    • 3
    • 6
  1. 1.INSERM, U1028/CNRS, UMR5292. Lyon Neuroscience Research CenterNeuro-Oncology and Neuro-inflammation TeamLyonFrance
  2. 2.Fédération d’Endocrinologie (GR, FBC), Service de Neurologie (FD, JH), Service de Neurochirurgie (EJ), Centre de Pathologie Est (JT), Groupement Hospitalier EstHospices Civils de LyonLyonFrance
  3. 3.Université de Lyon, Lyon1LyonFrance
  4. 4.Inserm U1052Centre de Recherche en Cancérologie de LyonLyonFrance
  5. 5.Service de radiothérapieCentre Hospitalier Universitaire Lyon SudPierre-BéniteFrance
  6. 6.Fédération d’Endocrinologie du Pole EstHospices Civils de LyonBron CedexFrance

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