Reference Detail

Ref Type

Journal Article

PMID

(27615706)

Authors

Donovan LE, Arnal AV, Wang SH, Odia Y

Title

Widely metastatic atypical pituitary adenoma with mTOR pathway STK11(F298L) mutation treated with everolimus therapy.

Journal	Vol	Issue	Date	Pages	Journal Short Title
CNS oncology	5	4	2016 Oct	203-9	CNS Oncol

URL

Abstract Text

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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Molecular Profile	Treatment Approach

Gene Name	Source	Synonyms	Protein Domains	Gene Description	Gene Role

Therapy Name	Drugs	Efficacy Evidence	Clinical Trials

Drug Name	Trade Name	Synonyms	Drug Classes	Drug Description

Gene	Variant	Impact	Protein Effect	Variant Description	Associated with drug Resistance
STK11	F298L	missense	unknown	STK11 F298L lies within the protein kinase domain of the Stk11 protein (UniProt.org). F298L has been identified in the scientific literature (PMID: 27615706), but has not been biochemically characterized and therefore, its effect on Stk11 protein function is unknown (PubMed, May 2024).

Molecular Profile	Indication/Tumor Type	Response Type	Therapy Name	Approval Status	Evidence Type	Efficacy Evidence	References
STK11 F298L	pituitary carcinoma	predicted - sensitive	Everolimus + Radiotherapy	Case Reports/Case Series	Actionable	In a clinical case study, a patient with adenocorticotropic pituitary carcinoma harboring STK11 F298L demonstrated stable disease and clinical benefit for greater than 6 months following treatment with Afinitor (everolimus), along with radiotherapy (PMID: 27615706).	27615706