Department of Neurosurgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Department of Neurology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA.
Pituitary. 2023 Aug;26(4):474-481. doi: 10.1007/s11102-023-01340-5. Epub 2023 Jul 10.
Aggressive prolactinomas are life-limiting tumors without a standard of care treatment option after the oral alkylator, temozolomide, fails to provide tumor control.
We reviewed an institutional database of pituitary tumors for patients with aggressive prolactinomas who progressed following treatment with a dopamine receptor agonist, radiotherapy and temozolomide. Within this cohort, we identified four patients who were treated with everolimus and we report their response to this therapy. Treatment response was determined by a neuroradiologist, who manually performed volumetric assessment and determined treatment response by Response Assessments in Neuro-Oncology (RANO) criteria.
Three of four patients who were treated with everolimus had a biochemical response to therapy and all patients derived a clinically meaningful benefit based upon suppression of tumor growth. While the best overall response as assessed by RANO criteria was stable disease for the four patients, a minor regression in tumor size was appreciated in two of the four patients.
Everolimus is an active agent in the treatment of prolactinomas that warrants further investigation.
侵袭性泌乳素瘤是一种生命受限的肿瘤，如果口服烷化剂替莫唑胺治疗后无法控制肿瘤，就没有标准的治疗选择。
我们回顾了一个垂体瘤的机构数据库，其中包括在接受多巴胺受体激动剂、放疗和替莫唑胺治疗后进展的侵袭性泌乳素瘤患者。在这一组中，我们确定了 4 名接受依维莫司治疗的患者，并报告了他们对这种治疗的反应。治疗反应由神经放射科医生确定，他们手动进行体积评估，并根据神经肿瘤学反应评估标准（RANO）确定治疗反应。
接受依维莫司治疗的 4 名患者中有 3 名有生化反应，所有患者都因肿瘤生长抑制而获得了有临床意义的获益。虽然根据 RANO 标准评估的整体最佳反应为 4 名患者的疾病稳定，但在 4 名患者中的 2 名中观察到肿瘤体积的轻微消退。
依维莫司是治疗泌乳素瘤的有效药物，值得进一步研究。
