Follow-up of pituitary tumor volume in patients with acromegaly treated with pegvisomant in clinical trials.

2.50
Hdl Handle:
http://hdl.handle.net/10541/81999
Title:
Follow-up of pituitary tumor volume in patients with acromegaly treated with pegvisomant in clinical trials.
Authors:
Jimenez, Camilo; Burman, Pia; Abs, Roger; Clemmons, David R; Drake, William M; Hutson, Kent R; Messig, Michael; Thorner, Michael O; Trainer, Peter J; Gagel, Robert F
Abstract:
OBJECTIVE: We examined pituitary tumor volumes in patients treated with pegvisomant for 18 months or longer, and in whom the tumors were monitored for at least 3 years. We present details on 9 of 304 patients in clinical trials with pegvisomant who experienced tumor growth within the first year of treatment. METHOD: Magnetic resonance images prior to start of pegvisomant and at last follow-up were examined in 43 patients (14% of participating patients). Twenty-nine had received prior radiation therapy (18% of irradiated patients) and all but five received somatostatin analogs between periods of pegvisomant treatment. RESULTS: At follow-up, the median tumor volume was 0.6 cc (range 0.0-19.7 cc), in comparison with 1.6 cc (0.0-19.7 cc) at baseline (P<0.001). Twenty-five patients, of which 23 received radiation therapy, had tumor volume reduction. Seventeen patients had no significant change. One patient, who had not received radiation therapy, had an increase in tumor volume from 1.61 to 1.93 cc. Of the nine patients with tumor growth, six had progressive growth before initiating pegvisomant. Two patients with stable tumors while on octreotide experienced enlargement after octreotide discontinuation but remained stable on long-term pegvisomant therapy. CONCLUSION: The present data indicate that pegvisomant does not promote tumor growth and suggest that the nine observed cases of tumor progression, which occurred within 8 months after commencing pegvisomant, are likely rebound expansions after discontinuation of somatostatin analogs and/or the natural history of aggressively growing pituitary tumors. Continued long-term surveillance of tumor volume, particularly in non-irradiated patients, is recommended.
Affiliation:
Department of Endocrine Neoplasia and Hormonal Disorders, The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030, USA.
Citation:
Follow-up of pituitary tumor volume in patients with acromegaly treated with pegvisomant in clinical trials. 2008, 159 (5):517-23 Eur. J. Endocrinol.
Journal:
European Journal of Endocrinology
Issue Date:
Nov-2008
URI:
http://hdl.handle.net/10541/81999
DOI:
10.1530/EJE-08-0205
PubMed ID:
18708436
Type:
Article
Language:
en
ISSN:
1479-683X
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorJimenez, Camilo-
dc.contributor.authorBurman, Pia-
dc.contributor.authorAbs, Roger-
dc.contributor.authorClemmons, David R-
dc.contributor.authorDrake, William M-
dc.contributor.authorHutson, Kent R-
dc.contributor.authorMessig, Michael-
dc.contributor.authorThorner, Michael O-
dc.contributor.authorTrainer, Peter J-
dc.contributor.authorGagel, Robert F-
dc.date.accessioned2009-09-22T11:29:58Z-
dc.date.available2009-09-22T11:29:58Z-
dc.date.issued2008-11-
dc.identifier.citationFollow-up of pituitary tumor volume in patients with acromegaly treated with pegvisomant in clinical trials. 2008, 159 (5):517-23 Eur. J. Endocrinol.en
dc.identifier.issn1479-683X-
dc.identifier.pmid18708436-
dc.identifier.doi10.1530/EJE-08-0205-
dc.identifier.urihttp://hdl.handle.net/10541/81999-
dc.description.abstractOBJECTIVE: We examined pituitary tumor volumes in patients treated with pegvisomant for 18 months or longer, and in whom the tumors were monitored for at least 3 years. We present details on 9 of 304 patients in clinical trials with pegvisomant who experienced tumor growth within the first year of treatment. METHOD: Magnetic resonance images prior to start of pegvisomant and at last follow-up were examined in 43 patients (14% of participating patients). Twenty-nine had received prior radiation therapy (18% of irradiated patients) and all but five received somatostatin analogs between periods of pegvisomant treatment. RESULTS: At follow-up, the median tumor volume was 0.6 cc (range 0.0-19.7 cc), in comparison with 1.6 cc (0.0-19.7 cc) at baseline (P<0.001). Twenty-five patients, of which 23 received radiation therapy, had tumor volume reduction. Seventeen patients had no significant change. One patient, who had not received radiation therapy, had an increase in tumor volume from 1.61 to 1.93 cc. Of the nine patients with tumor growth, six had progressive growth before initiating pegvisomant. Two patients with stable tumors while on octreotide experienced enlargement after octreotide discontinuation but remained stable on long-term pegvisomant therapy. CONCLUSION: The present data indicate that pegvisomant does not promote tumor growth and suggest that the nine observed cases of tumor progression, which occurred within 8 months after commencing pegvisomant, are likely rebound expansions after discontinuation of somatostatin analogs and/or the natural history of aggressively growing pituitary tumors. Continued long-term surveillance of tumor volume, particularly in non-irradiated patients, is recommended.en
dc.language.isoenen
dc.subject.meshAcromegaly-
dc.subject.meshAdenoma-
dc.subject.meshAdult-
dc.subject.meshAged-
dc.subject.meshAged, 80 and over-
dc.subject.meshAntineoplastic Agents, Hormonal-
dc.subject.meshClinical Trials as Topic-
dc.subject.meshCombined Modality Therapy-
dc.subject.meshDrug Therapy, Combination-
dc.subject.meshFemale-
dc.subject.meshFollow-Up Studies-
dc.subject.meshHuman Growth Hormone-
dc.subject.meshHumans-
dc.subject.meshInsulin-Like Growth Factor I-
dc.subject.meshMagnetic Resonance Imaging-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.subject.meshOctreotide-
dc.subject.meshPituitary Gland-
dc.titleFollow-up of pituitary tumor volume in patients with acromegaly treated with pegvisomant in clinical trials.en
dc.typeArticleen
dc.contributor.departmentDepartment of Endocrine Neoplasia and Hormonal Disorders, The University of Texas M.D. Anderson Cancer Center, Houston, Texas 77030, USA.en
dc.identifier.journalEuropean Journal of Endocrinologyen

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