Cargando…
Immunotherapy in Corticotroph and Lactotroph Aggressive Tumors and Carcinomas: Two Case Reports and a Review of the Literature
Once temozolomide has failed, no other treatment is recommended for pituitary carcinomas and aggressive pituitary tumors. Recently, the use of immune checkpoint inhibitors (ICIs) has raised hope, but so far, only one corticotroph carcinoma and one aggressive corticotroph tumor treated with immunothe...
Autores principales: | , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7563495/ https://www.ncbi.nlm.nih.gov/pubmed/32823651 http://dx.doi.org/10.3390/jpm10030088 |
_version_ | 1783595502251540480 |
---|---|
author | Duhamel, Camille Ilie, Mirela Diana Salle, Henri Nassouri, Adjoa Sika Gaillard, Stephan Deluche, Elise Assaker, Richard Mortier, Laurent Cortet, Christine Raverot, Gérald |
author_facet | Duhamel, Camille Ilie, Mirela Diana Salle, Henri Nassouri, Adjoa Sika Gaillard, Stephan Deluche, Elise Assaker, Richard Mortier, Laurent Cortet, Christine Raverot, Gérald |
author_sort | Duhamel, Camille |
collection | PubMed |
description | Once temozolomide has failed, no other treatment is recommended for pituitary carcinomas and aggressive pituitary tumors. Recently, the use of immune checkpoint inhibitors (ICIs) has raised hope, but so far, only one corticotroph carcinoma and one aggressive corticotroph tumor treated with immunotherapies have been reported in the literature. Here, we present two cases, one corticotroph carcinoma and one aggressive prolactinoma (the first one reported in the literature) treated with ipilimumab (1 mg/kg) and nivolumab (3 mg/kg) every three weeks, followed by maintenance treatment with nivolumab (3 mg/kg every 2 weeks) in the case of the corticotroph carcinoma, and we compare them with the two previously reported cases. Patient #1 presented a biochemical partial response (plasma ACTH decreased from 13,813 to 841 pg/mL) and dissociated radiological response to the combined ipilimumab and nivolumab—the pituitary mass decreased from 37 × 32 × 41 to 29 × 23 × 42 mm, and the pre-existing liver metastases decreased in size (the largest one from 45 to 14 mm) or disappeared, while a new 11-mm liver metastasis appeared. The maintenance nivolumab (21 cycles) resulted in a stable disease for the initial liver metastases, and in progressive disease for the newly appeared metastasis (effectively treated with radiofrequency ablation) and the pituitary mass. Patient #2 presented radiological and biochemical progressive disease after two cycles of ICIs—the pituitary mass increased from 38 × 42 × 26 to 53 × 57 × 44 mm, and the prolactin levels increased from 4410 to 9840 ng/mL. In conclusion, ICIs represent a promising therapeutic option for aggressive pituitary tumors and carcinomas. The identification of subgroups of responders will be key. |
format | Online Article Text |
id | pubmed-7563495 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-75634952020-10-27 Immunotherapy in Corticotroph and Lactotroph Aggressive Tumors and Carcinomas: Two Case Reports and a Review of the Literature Duhamel, Camille Ilie, Mirela Diana Salle, Henri Nassouri, Adjoa Sika Gaillard, Stephan Deluche, Elise Assaker, Richard Mortier, Laurent Cortet, Christine Raverot, Gérald J Pers Med Case Report Once temozolomide has failed, no other treatment is recommended for pituitary carcinomas and aggressive pituitary tumors. Recently, the use of immune checkpoint inhibitors (ICIs) has raised hope, but so far, only one corticotroph carcinoma and one aggressive corticotroph tumor treated with immunotherapies have been reported in the literature. Here, we present two cases, one corticotroph carcinoma and one aggressive prolactinoma (the first one reported in the literature) treated with ipilimumab (1 mg/kg) and nivolumab (3 mg/kg) every three weeks, followed by maintenance treatment with nivolumab (3 mg/kg every 2 weeks) in the case of the corticotroph carcinoma, and we compare them with the two previously reported cases. Patient #1 presented a biochemical partial response (plasma ACTH decreased from 13,813 to 841 pg/mL) and dissociated radiological response to the combined ipilimumab and nivolumab—the pituitary mass decreased from 37 × 32 × 41 to 29 × 23 × 42 mm, and the pre-existing liver metastases decreased in size (the largest one from 45 to 14 mm) or disappeared, while a new 11-mm liver metastasis appeared. The maintenance nivolumab (21 cycles) resulted in a stable disease for the initial liver metastases, and in progressive disease for the newly appeared metastasis (effectively treated with radiofrequency ablation) and the pituitary mass. Patient #2 presented radiological and biochemical progressive disease after two cycles of ICIs—the pituitary mass increased from 38 × 42 × 26 to 53 × 57 × 44 mm, and the prolactin levels increased from 4410 to 9840 ng/mL. In conclusion, ICIs represent a promising therapeutic option for aggressive pituitary tumors and carcinomas. The identification of subgroups of responders will be key. MDPI 2020-08-13 /pmc/articles/PMC7563495/ /pubmed/32823651 http://dx.doi.org/10.3390/jpm10030088 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Case Report Duhamel, Camille Ilie, Mirela Diana Salle, Henri Nassouri, Adjoa Sika Gaillard, Stephan Deluche, Elise Assaker, Richard Mortier, Laurent Cortet, Christine Raverot, Gérald Immunotherapy in Corticotroph and Lactotroph Aggressive Tumors and Carcinomas: Two Case Reports and a Review of the Literature |
title | Immunotherapy in Corticotroph and Lactotroph Aggressive Tumors and Carcinomas: Two Case Reports and a Review of the Literature |
title_full | Immunotherapy in Corticotroph and Lactotroph Aggressive Tumors and Carcinomas: Two Case Reports and a Review of the Literature |
title_fullStr | Immunotherapy in Corticotroph and Lactotroph Aggressive Tumors and Carcinomas: Two Case Reports and a Review of the Literature |
title_full_unstemmed | Immunotherapy in Corticotroph and Lactotroph Aggressive Tumors and Carcinomas: Two Case Reports and a Review of the Literature |
title_short | Immunotherapy in Corticotroph and Lactotroph Aggressive Tumors and Carcinomas: Two Case Reports and a Review of the Literature |
title_sort | immunotherapy in corticotroph and lactotroph aggressive tumors and carcinomas: two case reports and a review of the literature |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7563495/ https://www.ncbi.nlm.nih.gov/pubmed/32823651 http://dx.doi.org/10.3390/jpm10030088 |
work_keys_str_mv | AT duhamelcamille immunotherapyincorticotrophandlactotrophaggressivetumorsandcarcinomastwocasereportsandareviewoftheliterature AT iliemireladiana immunotherapyincorticotrophandlactotrophaggressivetumorsandcarcinomastwocasereportsandareviewoftheliterature AT sallehenri immunotherapyincorticotrophandlactotrophaggressivetumorsandcarcinomastwocasereportsandareviewoftheliterature AT nassouriadjoasika immunotherapyincorticotrophandlactotrophaggressivetumorsandcarcinomastwocasereportsandareviewoftheliterature AT gaillardstephan immunotherapyincorticotrophandlactotrophaggressivetumorsandcarcinomastwocasereportsandareviewoftheliterature AT delucheelise immunotherapyincorticotrophandlactotrophaggressivetumorsandcarcinomastwocasereportsandareviewoftheliterature AT assakerrichard immunotherapyincorticotrophandlactotrophaggressivetumorsandcarcinomastwocasereportsandareviewoftheliterature AT mortierlaurent immunotherapyincorticotrophandlactotrophaggressivetumorsandcarcinomastwocasereportsandareviewoftheliterature AT cortetchristine immunotherapyincorticotrophandlactotrophaggressivetumorsandcarcinomastwocasereportsandareviewoftheliterature AT raverotgerald immunotherapyincorticotrophandlactotrophaggressivetumorsandcarcinomastwocasereportsandareviewoftheliterature |