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在没有保险覆盖的情况下使用temozolomide的情况在患有侵袭性垂体神经内分泌瘤的患者中

Atsushi Ishida¹, Naoko Inoshita², Noriaki Tanabe²

¹Hypothalamic & Pituitary Center, Moriyama Memorial Hospital, Tokyo 134-0081, Japan.

Endocrine journal

|March 12, 2025

概括

泰莫佐洛米德 (Temozolomide,简称TMZ) 是对瘤 (PitNETs) 的第一线治疗,但在保险覆盖和O6-甲基瓜因-DNA甲基转移酶 (MGMT) 表达方面面临挑战. 与capecitabine (CAPTEM) 联合治疗显示出有前途的结果.

科学领域:

内分泌学在内分泌学.
在瘤学瘤学.
神经外科神经外科

背景情况:

侵袭性垂体神经内分泌瘤 (PitNETs) 由于侵入性和对标准疗法的耐药性而具有挑战性.
泰莫佐洛米德 (TMZ) 是目前的第一线治疗,但其使用受到保险覆盖和O6-甲基瓜因-DNA甲基转移酶 (MGMT) 表达的限制.
之前的研究表明,capecitabine和temozolomide联合治疗 (CAPTEM) 的潜在疗效.

研究的目的:

描述在患有侵袭性垂体神经内分泌瘤 (PitNETs) 的患者中使用temozolomide (TMZ) 的临床经验.
评估TMZ的有效性和耐受性,包括与capecitabine (CAPTEM) 联合治疗.
确定与日本TMZ治疗侵略性PitNETs相关的挑战.

主要方法:

用TMZ治疗的13名具有侵略性PitNET患者的回顾性分析.
四名患者接受了组合疗法 (CAPTEM).
病理亚型包括皮质瘤,乳质瘤和体质瘤.

主要成果:

七名患者继续接受治疗;六名患者因疗效不佳,财务原因或患者偏好而终止治疗.
没有报告由于不良事件而停止治疗.
一名患有乳腺瘤的患者通过CAPTEM实现了缓解,并且在治疗后15个月内保持了缓解.

结论:

泰莫佐洛米德 (TMZ) 是一种可行的治疗选择,用于积极的垂体神经内分泌瘤 (PitNETs),具有良好的安全性.
财务限制和保险覆盖面对治疗的可及性和持续性产生重大影响.
非标签使用TMZ和CAPTEM对广泛的临床采用提出了挑战.

关键词:

有侵略性的垂体神经内分泌瘤.卡佩西塔是一种素.O6 甲基氨酸 DNA 甲基转移酶泰莫佐洛米德 (Temozolomide) 是一种一种

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