Widely Metastatic Atypical Pituitary Adenoma with MTOR Pathway STK11(F298L) Mutation Treated with Everolimus Therapy

Overview

Journal CNS Oncol

Specialty Oncology

Date 2016 Sep 13

PMID 27615706

Citations 28

Authors

Laura E Donovan

Ashley V Arnal

Shih-Hsiu Wang

Yazmin Odia

Affiliations

Soon will be listed here.

Abstract

Pituitary adenomas are the commonest intracranial tumor, but metastases are rare (0.2% yearly incidence) and portend poor prognosis. CAPecitabine and TEMozolomide improved outcomes for neuroendocrine tumors. However, no chemotherapy is approved for refractory pituitary carcinomas. Next-generation sequencing revealed an actionable mTOR pathway STK11 mutation in a woman with adrenocorticotropic hormone-secreting pituitary carcinoma refractory to six resections, radiation and CAPecitabine and TEMozolomide. Given efficacy in preclinical pancreatic cancer models with STK11 mutations, she received radiation and everolimus leading to clinical improvement and stability on MRI and PET for >6 months. She ultimately expired from widely metastatic disease. Next-generation sequencing can identify actionable mutations in rare or treatment refractory tumors. Earlier targeted therapy may improve outcomes.

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