Temozolomide is the main chemotherapy drug used for aggressive pituitary tumors and pituitary carcinomas that do not respond to standard treatments like surgery or radiation. Most of what is known about how well this treatment works comes from small studies in Europe and the United States, with very little data from Latin America. Building on a previous multicenter study conducted in Brazil, this study (TEMPLA) expands data collection to additional centers across Latin America to better understand how patients in this region respond to temozolomide, how long the treatment controls the tumor, and whether certain tumor characteristics (such as MGMT status) can help predict which patients are more likely to benefit.
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The study population consists of patients diagnosed with aggressive pituitary neuroendocrine tumors (PitNETs) or pituitary carcinomas who were treated with temozolomide as part of routine clinical management at participating centers across Latin America, including a previously established Brazilian multicenter cohort. Patients were identified retrospectively through review of institutional pathology, oncology, and endocrinology records. The population reflects real-world clinical practice, encompassing diverse tumor subtypes (functioning and non-functioning PitNETs) and variable temozolomide dosing protocols, rather than a population selected under a standardized experimental treatment regimen.
Cohort
Retrospective
temozolamide
DrugTemozolomide, an oral alkylating chemotherapeutic agent, administered as part of routine clinical management for aggressive pituitary neuroendocrine tumors (PitNETs) and pituitary carcinomas refractory to standard therapy. Dosing regimens, cycle duration, and total number of cycles varied according to each treating center's clinical protocol and were not standardized as part of this study. Temozolomide was not assigned by the investigators for research purposes; all treatment decisions were made independently by the treating clinical team prior to data collection
Temozolamide
DrugUnlike most published temozolomide studies in aggressive pituitary tumors, which are limited to single-center case series from Europe or North America, this cohort captures multicenter, real-world temozolomide use specifically in Latin American patients with aggressive PitNETs and pituitary carcinomas. Data include MGMT status (immunohistochemistry and/or promoter methylation) as an exploratory predictor of response, collected under heterogeneous but harmonized dosing protocols reflecting routine clinical practice across participating centers, rather than a standardized experimental regimen.
Radiological Response Rate to Temozolomide
Radiological response
Radiological response to temozolomide will be classified as complete response, partial response, stable disease, or progressive disease, based on comparison of pre-treatment and post-treatment imaging (MRI) available for each patient. Response classification will follow criteria adapted from RECIST where applicable, acknowledging that formal RECIST assessment may not have been systematically applied at the time of clinical treatment in all participating centers.
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