A Case Series of Temozolomide in the Management of Refractory Prolactinomas

Abstract

Objective: To report three cases of refractory prolactinomas treated with Temozolomide (TMZ). Background: Prolactinomas account for 40% of pituitary adenomas. Dopamine agonists (DA) are the first line of treatment followed by surgical resection and radiation. TMZ is an oral chemotherapeutic agent used in gliomas, which has been given to patients with prolactinomas refractory to conventional treatments. Methods: Retrospective chart review was conducted for refractory prolactinoma patients treated between 2008 and 2018 at UT Southwestern Medical Center (UTSW). Three patients with refractory prolactinomas received oral TMZ at UTSW. Results: All three patients demonstrated improvement in symptoms upon TMZ treatment, markedly decreased serum prolactin levels (SPRL), as well as radiographic decrease in tumor size.