Case Report

Chemotherapy-Induced Regression of an Adrenocorticotropin-Secreting Pituitary Carcinoma Accompanied by Secondary Adrenal Insufficiency

Table 1

Chemotherapy in metastatic pituitary corticotroph carcinomas.

Author, year of publicationAgeGenderMetastatic sitesChemotherapyChemotherapy cycles/duration, doses, and responseTreatments prior to chemotherapyKi-67Patient outcome

Farrell et al., 2003 [12]34FPelvic, vertebrae, and ribsVCR, carboplatin, and etoposideNot toleratedTSS, XRT, metyrapone, ketoconazole, SR, TMZ, bADX, and OCT3%Death from progression
Gaffey et al., 2002 [13]59FLiverCTX, VCR, and dacarbazine8 cycles
lowered ACTH from 3000 pg/mL to 450 pg/mL
TSS, bADX, XRT, SR, and OCTNRAlive at publication
Jouanneau et al., 2012 [14]45MCraniocervicalEverolimus3 months, progressive diseaseTMZ, pituitary surgery, SR, XRT, and bADXLowDeath from progression
Kaiser et al., 1983 [15]17FLiver, lung, pelvis, vertebrae, and mediastinumAdriamycin, 5-FU, and CTX4 Cycles
lowered 1800 h IR-ACTH from 175,000 pg/mL to 75,000 pg/mL
Pituitary surgery, XRT, and bADXNRAlive at publication
Moshkin et al., 2011 [16] 38MVertebraeBevacizumab16 months, stable diseaseTSS, XRT, and TMZ1–5%Alive at publication
Nawata et al., 1990 [17]53MLiver, lung, and brainMitotane and HCFUProgressive diseasePituitary surgery, XRTDeath from progression
Raverot et al., 2010 [7]31
MNRBCNU and TMZ6 cycles of combination therapy, progressive diseaseTSS, SR, TMZ, and bADX20%NR
Thearle et al., 2011 [18]50MBone, vertebraeCapecitabine and TMZ
Cisplatin and etoposide
4 cycles
lowered ACTH from 1874 pg/mL to 85 pg/mL
2 cycles,
40% decrease in tumor volume on MRI brain
TSS, gamma knife, ketoconazole, metyrapone, OCT, bADX, cabergoline, and rosiglitazone31%Enrolled in hospice after 2 cycles of cisplatin and etoposide
Van der Klaauw et al., 2009 [4]23MBone, liverDoxorubicin, CTX, and etoposide2 cycles, not toleratedXRT, ketoconazole, TSS, brachytherapy, bADX, and OCTNRDeath from progression

bADX: bilateral adrenalectomy; BCNU: carmustine; CTX: cyclophosphamide; DA: dopamine agonists; 5-FU: fluorouracil; HCFU (carmofur): 1-hexylcarbamoyl-5-fluorouracil; OCT: octreotide; SA: somatostatin analogs; SR: stereotactic radiosurgery; TMZ: temozolomide; TSS: transsphenoidal surgery; VCR: vincristine; XRT: external beam radiation therapy; NR: not reported; IR-ACTH: immunoreactive ACTH (normal range 5–45 pg/mL at 1800 h).