TABLE 1.
Temozolomide treatment cohort
| Case no. | Surgery | Cell lineage | Tumor features | Radiation therapy | MGMT score | Temozolomide | Response | Side effects | Outcome | ||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Biochemical | Imaging | ||||||||||
| 1 | TSR: 10/08 | Null-cell | Ki-67 < 3%; prominent nucleoli | None | 3 | 10 of 12 cycles completed | N/A | 20% reduction in tumor volume; subsequent stable tumor volume | Fatigue, headaches | Clinically stable | |
| 2 | TSR: 07/04; craniectomies: 07/07; 06/09 | Corticotroph-cell with clinical Cushing’s disease | Ki-67 = 18%; p53 +; large, multinucleated cells | GKRT 10/18/07; 5/02/08 | 1 | 11 completed | ACTH: 221 pg/ml decreased to 18 ng/ml; adrenally insufficient at cycle 8/11 | >80% tumor reduction | Sensory neural hearing loss, fatigue, headaches | Clinically improved during treatment | |
| 3 | TSR: 01/92; 06/03; 12/06 | FSH/TSH/α-SU positive; clinically nonfunctional | Ki-67 < 3%; no atypical features | Conventional fractionated radiation 1992 | 2 | 13 completed, still on tx; 12 cycles of 21/7, now on 18/10 | N/A | Stable tumor size | Fatigue and headaches, lessened with dose reduction | Clinically stable | |
| 4 | TSR: 07/94; 02/00 | Null-cell | Ki-67 = 6%; mitotic figures present | None | 3 | 10/12 completed | N/A | Stable tumor size | Fatigue, dry mouth | Clinically stable | |
| 5 | TSR: 08/06; 12/06 | Prolactinoma | Ki-67 > 20%; prominent nucleoli | GKRT 02/2007 | 1 | 11 completed still on tx 21/7 | Prolactin: 5702 ng/ml decreased to 121 ng/ml | >80% tumor reduction | Well tolerated | Clinically improved during treatment | |
| 6 | TSR: 06/94; 10/01; 04/03 | Pituitary carcinoma; null-cell | Ki-67 > 20%; brisk mitotic activity | Conventional fractionated radiation 1994; GKRT 02/05 | 3 | 2 cycles, Apr/May 2005 temodar/ thalidomide | N/A | Stable tumor size during 2 months of treatment | Fatigue, severe dizziness | Deceased; cause of death unrelated to pituitary carcinoma | |
| 7 | TSR: 01/05; 03/05 | Pituitary carcinoma; null-cell | Ki-67 > 20%; rare mitotic figures | IMRT 04/05 | 1 | 7 cycles | N/A | Progressive metastatic disease on treatment | Fatigue, headaches | Deceased; death attributed to complications of pituitary carcinoma | |
TSR, Transsphenoidal surgery; GKRT, GammaKnife radiation treatment; IMRT, intensity modulated radiation therapy; N/A, not available; tx, treatment; α-SU, α-subunit of glycoproteins. Median MGMT IHC score reported for each case (1 = <10% MGMT positive cells; 2 = 10%–50% MGMT positive cells; 3 = >50% MGMT positive cells).