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The treatment of aggressive prolactinomas with everolimus

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Abstract

Introduction

Aggressive prolactinomas are life-limiting tumors without a standard of care treatment option after the oral alkylator, temozolomide, fails to provide tumor control.

Methods

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.

Results

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.

Conclusion

Everolimus is an active agent in the treatment of prolactinomas that warrants further investigation.

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Funding

This research was funded in part through the National Institutes of Health/National Cancer Institute Cancer Center Support Grand P30 CA008748.

Author information

Authors and Affiliations

  1. Department of Neurosurgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Andrew L. Lin, Eliza B. Geer & Viviane Tabar

  2. Department of Neurology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA

    Andrew L. Lin & Nupur Lala

  3. Multidisciplinary Pituitary and Skull Base Tumor Center, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Andrew L. Lin, Eliza B. Geer & Viviane Tabar

  4. Department of Neurology, Weill Cornell Medical College, New York, NY, USA

    Andrew L. Lin & Rajiv Magge

  5. Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Eliza B. Geer

  6. Department of Medicine, Columbia University Medical Center, New York, NY, USA

    Gabrielle Page-Wilson

  7. Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Robert J. Young

Authors
  1. Andrew L. Lin
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  2. Eliza B. Geer
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  3. Nupur Lala
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  4. Gabrielle Page-Wilson
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  6. Robert J. Young
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  7. Viviane Tabar
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Contributions

All authors contributed to the acquisition, analysis, or interpretation of the data. AL—wrote the main manuscript text and prepared the figures. All authors reviewed the manuscript and approved the final version.

Corresponding author

Correspondence to Andrew L. Lin.

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Conflict of interest

Andrew L. Lin reports that he has received funding from Bristol-Myers Squibb. Robert J. Young reports that he has consulted for Olea Sphere and ICON plc, unrelated to this work. The remaining authors have nothing to disclose.

Ethical approval

This study was conducted using a waiver of informed consent that was approved by the Memorial Sloan Kettering Cancer Center Institutional Review Board.

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Lin, A.L., Geer, E.B., Lala, N. et al. The treatment of aggressive prolactinomas with everolimus. Pituitary 26, 474–481 (2023). https://doi.org/10.1007/s11102-023-01340-5

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  • DOI: https://doi.org/10.1007/s11102-023-01340-5

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