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01.06.2019 | Review Article

Medical therapy for non-functioning pituitary tumors—a critical approach

verfasst von: Metaxia Tampourlou, Olga Karapanou, Dimitra A. Vassiliadi, Stylianos Tsagarakis

Erschienen in: Hormones | Ausgabe 2/2019

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Abstract

Non-functioning pituitary adenomas (NFPAs) are the second most common variant of pituitary tumors. When symptomatic, primary therapy is surgery. Recurrence rates are high. Since many NFPAs express dopamine and somatostatin receptors, medical therapy has been used after surgery in order to prevent recurrence. So far, dopamine agonists have been more widely tested with some promise when introduced immediately after surgery but with less efficacy when introduced later upon tumor regrowth. Currently, the role of medical therapy to prevent tumor regrowth in NFPAs is limited by imprecisions as to final outcome and uncertainties concerning on patient selection, dosing, duration, and side effects.

Gruppetta M, Mercieca C, Vassallo J (2013) Prevalence and incidence of pituitary adenomas: a population based study in Malta. Pituitary 16:545–553. https://doi.org/10.1007/s11102-012-0454-0 CrossRefPubMed

Al-Dahmani K, Mohammad S, Imran F (2016) Sellar masses: an epidemiological study. Can J Neurol Sci 43:291–297. https://doi.org/10.1017/cjn.2015.301 CrossRefPubMed

Daly AF, Rixhon M, Adam C, Dempegioti A, Tichomirowa MA, Beckers A (2006) High prevalence of pituitary adenomas: a cross-sectional study in the province of Liege, Belgium. J Clin Endocrinol Metab 91:4769–4775. https://doi.org/10.1210/jc.2006-1668 CrossRefPubMed

Fernandez A, Karavitaki N, Wass JA (2010) Prevalence of pituitary adenomas: a community-based, cross-sectional study in Banbury (Oxfordshire, UK). Clin Endocrinol 72:377–382. https://doi.org/10.1111/j.1365-2265.2009.03667.x CrossRef

Losa M, Donofrio CA, Barzaghi R, Mortini P (2013) Presentation and surgical results of incidentally discovered nonfunctioning pituitary adenomas: evidence for a better outcome independently of other patients’ characteristics. Eur J Endocrinol 169:735–742. https://doi.org/10.1530/EJE-13-0515 CrossRefPubMed

Freda PU, Beckers AM, Katznelson L et al (2011) Pituitary incidentaloma: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 96:894–904. https://doi.org/10.1210/jc.2010-1048 CrossRefPubMedPubMedCentral

Chen Y, Wang CD, Su ZP et al (2012) Natural history of postoperative nonfunctioning pituitary adenomas: a systematic review and meta-analysis. Neuroendocrinology 96:333–342. https://doi.org/10.1159/000339823 CrossRefPubMed

Greenman Y, Stern N (2009) How should a nonfunctioning pituitary macroadenoma be monitored after debulking surgery? Clin Endocrinol 70:829–832. https://doi.org/10.1111/j.1365-2265.2009.03542.x CrossRef

Pivonello R, Matrone C, Filippella M et al (2004) Dopamine receptor expression and function in clinically nonfunctioning pituitary tumors: comparison with the effectiveness of cabergoline treatment. J Clin Endocrinol Metab 89:1674–1683. https://doi.org/10.1210/jc.2003-030859 CrossRefPubMed

10.

Greenman Y, Cooper O, Yaish I et al (2016) Treatment of clinically nonfunctioning pituitary adenomas with dopamine agonists. Eur J Endocrinol 175:63–72. https://doi.org/10.1530/EJE-16-0206 CrossRefPubMed

11.

Mete O, Lopes MB (2017) Overview of the 2017 WHO classification of pituitary tumors. Endocr Pathol 28:228–243. https://doi.org/10.1007/s12022-017-9498-z CrossRefPubMed

12.

Asa SL (2008) Practical pituitary pathology: what does the pathologist need to know? Arch Pathol Lab Med 132:1231–1240. https://doi.org/10.1043/1543-2165(2008)132[1231:PPPWDT]2.0.CO;2

13.

Knosp E, Steiner E, Kitz K, Matula C (1993) Pituitary adenomas with invasion of the cavernous sinus space: a magnetic resonance imaging classification compared with surgical findings. Neurosurgery 33:610–617PubMed

14.

Chuang CC, Lin SY, Pai PC, Yan JL, Toh CH, Lee ST et al (2017) Different volumetric measurement methods for pituitary adenomas and their crucial clinical significance. Sci Rep 7:40792. https://doi.org/10.1038/srep40792 CrossRefPubMedPubMedCentral

15.

Bevan JS, Webster J, Burke CW, Scanlon MF (1992) Dopamine agonists and pituitary tumor shrinkage. Endocr Rev 13:220–240. https://doi.org/10.1210/edrv-13-2-220 CrossRefPubMed

16.

Day PF, Guitelman M, Artese R et al (2004) Retrospective multicentric study of pituitary incidentalomas. Pituitary 7:145–148. https://doi.org/10.1007/s11102-005-1757-1 CrossRefPubMed

17.

Dekkers OM, Hammer S, de Keizer RJ et al (2007) The natural course of nonfunctioning pituitary macroadenomas. Eur J Endocrinol 156:217–224. https://doi.org/10.1530/eje.1.02334 CrossRefPubMed

18.

Rogers A, Karavitaki N, Wass JA (2014) Diagnosis and management of prolactinomas and non-functioning pituitary adenomas. BMJ 349:g5390. https://doi.org/10.1136/bmj.g5390 CrossRefPubMed

19.

Ferrante E, Ferraroni M, Castrignano T et al (2006) Non-functioning pituitary adenoma database: a useful resource to improve the clinical management of pituitary tumors. Eur J Endocrinol 155:823–829. https://doi.org/10.1530/eje.1.02298 CrossRefPubMed

20.

Serhal D, Weil RJ, Hamrahian AH (2008) Evaluation and management of pituitary incidentalomas. Cleve Clin J Med 75:793–801CrossRefPubMed

21.

Ciric I, Ragin A, Baumgartner C, Pierce D (1997) Complications of transsphenoidal surgery: results of a national survey, review of the literature, and personal experience. Neurosurgery 40:225–236CrossRefPubMed

22.

Woollons AC, Hunn MK, Rajapakse YR et al (2000) Non-functioning pituitary adenomas: indications for postoperative radiotherapy. Clin Endocrinol 53:713–717CrossRef

23.

Roelfsema F, Biermasz NR, Pereira AM (2012) Clinical factors involved in the recurrence of pituitary adenomas after surgical remission: a structured review and meta-analysis. Pituitary 15:71–83. https://doi.org/10.1007/s11102-011-0347-7 CrossRefPubMed

24.

Kremer P, Forsting M, Ranaei G et al (2002) Magnetic resonance imaging after transsphenoidal surgery of clinically non-functional pituitary macroadenomas and its impact on detecting residual adenoma. Acta Neurochir 144:433–443. https://doi.org/10.1007/s007010200064 CrossRefPubMed

25.

Mortini P, Barzaghi R, Losa M, Boari N, Giovanelli M (2007) Surgical treatment of giant pituitary adenomas: strategies and results in a series of 95 consecutive patients. Neurosurgery 60:993–1002. https://doi.org/10.1227/01.NEU.0000255459.14764.BA CrossRefPubMed

26.

Gnanalingham KK, Bhattacharjee S, Pennington R, Ng J, Mendoza N (2005) The time course of visual field recovery following transphenoidal surgery for pituitary adenomas: predictive factors for a good outcome. J Neurol Neurosurg Psychiatry 76:415–419. https://doi.org/10.1136/jnnp.2004.035576 CrossRefPubMedPubMedCentral

27.

Molitch ME (2008) Nonfunctioning pituitary tumors and pituitary incidentalomas. Endocrinol Metab Clin N Am 37:151–171. https://doi.org/10.1016/j.ecl.2007.10.011 CrossRef

28.

Comtois R, Beauregard H, Somma M, Serri O, Aris-Jilwan N, Hardy J (1991) The clinical and endocrine outcome to trans-sphenoidal microsurgery of nonsecreting pituitary adenomas. Cancer 68:860–866CrossRefPubMed

29.

Park P, Chandler WF, Barkan AL et al (2004) The role of radiation therapy after surgical resection of nonfunctional pituitary macroadenomas. Neurosurgery 55:100–106CrossRefPubMed

30.

Tampourlou M, Ntali G, Ahmed S et al (2017) Outcome of nonfunctioning pituitary adenomas that regrow after primary treatment: a study from two large UK centers. J Clin Endocrinol Metab 102:1889–1897. https://doi.org/10.1210/jc.2016-4061 CrossRefPubMed

31.

Dubois S, Guyetant S, Menei P et al (2007) Relevance of Ki-67 and prognostic factors for recurrence/progression of gonadotropic adenomas after first surgery. Eur J Endocrinol 157:141–147. https://doi.org/10.1530/EJE-07-0099 CrossRefPubMed

32.

Reddy R, Cudlip S, Byrne JV, Karavitaki N, Wass JA (2011) Can we ever stop imaging in surgically treated and radiotherapy-naive patients with non-functioning pituitary adenoma? Eur J Endocrinol 165:739–744. https://doi.org/10.1530/EJE-11-0566 CrossRefPubMed

33.

Brochier S, Galland F, Kujas M et al (2010) Factors predicting relapse of nonfunctioning pituitary macroadenomas after neurosurgery: a study of 142 patients. Eur J Endocrinol 163:193–200. https://doi.org/10.1530/EJE-10-0255 CrossRefPubMed

34.

Chang EF, Zada G, Kim S et al (2008) Long-term recurrence and mortality after surgery and adjuvant radiotherapy for nonfunctional pituitary adenomas. J Neurosurg 108:736–745. https://doi.org/10.3171/JNS/2008/108/4/0736 CrossRefPubMed

35.

Yang SY, Zhu T, Zhang JN, Sun YS (1994) Transsphenoidal microsurgical management of pituitary adenomas. Microsurgery 15:754–759CrossRefPubMed

36.

Jaffrain-Rea ML, Derome P, Bataini JP et al (1993) Influence of radiotherapy on long-term relapse in clinically non-secreting pituitary adenomas. A retrospective study (1970-1988). Eur J Med 2(7):398–403PubMed

37.

Losa M, Mortini P, Barzaghi R et al (2008) Early results of surgery in patients with nonfunctioning pituitary adenoma and analysis of the risk of tumor recurrence. J Neurosurg 108:525–532. https://doi.org/10.3171/JNS/2008/108/3/0525 CrossRefPubMed

38.

Raverot G, Dantony E, Beauvy J et al (2017) Risk of recurrence in pituitary neuroendocrine tumors: a prospective study using a five-tiered classification. J Clin Endocrinol Metab 102:3368–3374. https://doi.org/10.1210/jc.2017-00773 CrossRefPubMed

39.

Dekkers OM, Pereira AM, Roelfsema F et al (2006) Observation alone after transsphenoidal surgery for nonfunctioning pituitary macroadenoma. J Clin Endocrinol Metab 91:1796–1801. https://doi.org/10.1210/jc.2005-2552 CrossRefPubMed

40.

O’Sullivan EP, Woods C, Glynn N et al (2009) The natural history of surgically treated but radiotherapy-naive nonfunctioning pituitary adenomas. Clin Endocrinol 71:709–714. https://doi.org/10.1111/j.1365-2265.2009.03583.x CrossRef

41.

Greenman Y, Ouaknine G, Veshchev I, Reider-Groswasser II, Segev Y, Stern N (2003) Postoperative surveillance of clinically nonfunctioning pituitary macroadenomas: markers of tumour quiescence and regrowth. Clin Endocrinol 58:763–769CrossRef

42.

Ratnasingam J, Lenders N, Ong B et al (2017) Predictors for secondary therapy after surgical resection of nonfunctioning pituitary adenomas. Clin Endocrinol 87:717–724. https://doi.org/10.1111/cen.13402 CrossRef

43.

Loeffler JS, Shih HA (2011) Radiation therapy in the management of pituitary adenomas. J Clin Endocrinol Metab 96:1992–2003. https://doi.org/10.1210/jc.2011-0251 CrossRefPubMed

44.

Sheehan JP, Starke RM, Mathieu D et al (2013) Gamma Knife radiosurgery for the management of nonfunctioning pituitary adenomas: a multicenter study. J Neurosurg 119:446–456. https://doi.org/10.3171/2013.3.JNS12766 CrossRefPubMed

45.

Gittoes NJ, Bates AS, Tse W et al (1998) Radiotherapy for non-function pituitary tumours. Clin Endocrinol 48:331–337CrossRef

46.

Wilson PJ, De-Loyde KJ, Williams JR, Smee RI (2012) A single centre’s experience of stereotactic radiosurgery and radiotherapy for non-functioning pituitary adenomas with the Linear Accelerator (Linac). J Clin Neurosci 19:370–374. https://doi.org/10.1016/j.jocn.2011.07.025 CrossRefPubMed

47.

Iwata H, Sato K, Tatewaki K et al (2011) Hypofractionated stereotactic radiotherapy with CyberKnife for nonfunctioning pituitary adenoma: high local control with low toxicity. Neuro-Oncology 13:916–922. https://doi.org/10.1093/neuonc/nor055 CrossRefPubMedPubMedCentral

48.

Minniti G, Scaringi C, Poggi M et al (2015) Fractionated stereotactic radiotherapy for large and invasive non-functioning pituitary adenomas: long-term clinical outcomes and volumetric MRI assessment of tumor response. Eur J Endocrinol 172:433–441. https://doi.org/10.1530/EJE-14-0872 CrossRefPubMed

49.

Burman P, van Beek AP, Biller BM, Camacho-Hübner C, Mattsson AF (2017) Radiotherapy, especially at young age, increases the risk for de novo brain tumors in patients treated for pituitary/sellar lesions. J Clin Endocrinol Metab 102:1051–1058. https://doi.org/10.1210/jc.2016-3402 CrossRefPubMed

50.

van Varsseveld NC, van Bunderen CC, Ubachs DH et al (2015) Cerebrovascular events, secondary intracranial tumors, and mortality after radiotherapy for nonfunctioning pituitary adenomas: a subanalysis from the Dutch National Registry of Growth Hormone Treatment in Adults. J Clin Endocrinol Metab 100:1104–1112. https://doi.org/10.1210/jc.2014-3697 CrossRefPubMed

51.

Neto LV, Machado Ede O, Luque RM et al (2009) Expression analysis of dopamine receptor subtypes in normal human pituitaries, nonfunctioning pituitary adenomas and somatotropinomas, and the association between dopamine and somatostatin receptors with clinical response to octreotide-LAR in acromegaly. J Clin Endocrinol Metab 94:1931–1937. https://doi.org/10.1210/jc.2008-1826 CrossRefPubMedPubMedCentral

52.

Gabalec F, Beranek M, Netuka D et al (2012) Dopamine 2 receptor expression in various pathological types of clinically non-functioning pituitary adenomas. Pituitary 15:222–226. https://doi.org/10.1007/s11102-011-0316-1 CrossRefPubMed

53.

Florio T, Barbieri F, Spaziante R et al (2008) Efficacy of a dopamine-somatostatin chimeric molecule, BIM-23A760, in the control of cell growth from primary cultures of human non-functioning pituitary adenomas: a multi-center study. Endocr Relat Cancer 15:583–596. https://doi.org/10.1677/ERC-07-0271 CrossRefPubMed

54.

Colao A, Di Somma C, Pivonello R, Faggiano A, Lombardi G, Savastano S (2008) Medical therapy for clinically nonfunctioning pituitary adenomas. Endocr Relat Cancer 15:905–915. https://doi.org/10.1677/ERC-08-0181 CrossRefPubMed

55.

Vieira Neto L, Wildemberg LE, Moraes AB et al (2015) Dopamine receptor subtype 2 expression profile in nonfunctioning pituitary adenomas and in vivo response to cabergoline therapy. Clin Endocrinol 82:739–746. https://doi.org/10.1111/cen.12684 CrossRef

56.

Garcia EC, Naves LA, Silva AO, de Castro LF, Casulari LA, Azevedo MF (2013) Short-term treatment with cabergoline can lead to tumor shrinkage in patients with nonfunctioning pituitary adenomas. Pituitary 16:189–194. https://doi.org/10.1007/s11102-012-0403-y CrossRefPubMed

57.

Gillam MP, Molitch ME, Lombardi G, Colao A (2006) Advances in the treatment of prolactinomas. Endocr Rev 27:485–534. https://doi.org/10.1210/er.2005-9998 CrossRefPubMed

58.

Moore TJ, Glenmullen J, Mattison DR (2014) Reports of pathological gambling, hypersexuality, and compulsive shopping associated with dopamine receptor agonist drugs. JAMA Intern Med 174:1930–1933. https://doi.org/10.1001/jamainternmed.2014.5262 CrossRefPubMed

59.

Valassi E, Klibanski A, Biller BM (2010) Clinical review#: potential cardiac valve effects of dopamine agonists in hyperprolactinemia. J Clin Endocrinol Metab 95:1025–1033. https://doi.org/10.1210/jc.2009-2095 CrossRefPubMed

60.

Drake WM, Stiles CE, Howlett TA, Toogood AA, Bevan JS, Steeds RP (2014) A cross sectional study of the prevalence of cardiac valvular abnormalities in hyperprolactinemic patients treated with ergot-derived dopamine agonists. J Clin Endocrinol Metab 99:90–96. https://doi.org/10.1210/jc.2013-2254 CrossRefPubMed

61.

de Herder WW, Reijs AE, Feelders RA et al (2007) Diagnostic imaging of dopamine receptors in pituitary adenomas. Eur J Endocrinol 156:S53–S56. https://doi.org/10.1530/eje.1.02349 CrossRefPubMed

62.

Gabalec F, Drastikova M, Cesak T et al (2015) Dopamine 2 and somatostatin 1-5 receptors coexpression in clinically non-functioning pituitary adenomas. Physiol Res 64:369–377PubMed

63.

Saveanu A, Jaquet P (2009) Somatostatin-dopamine ligands in the treatment of pituitary adenomas. Rev Endocr Metab Disord 10:83–90. https://doi.org/10.1007/s11154-008-9086-0 CrossRefPubMed

64.

Taboada GF, Luque RM, Bastos W et al (2007) Quantitative analysis of somatostatin receptor subtype (SSTR1-5) gene expression levels in somatotropinomas and non-functioning pituitary adenomas. Eur J Endocrinol 156:65–74. https://doi.org/10.1530/eje.1.02313 CrossRefPubMed

65.

Ramirez C, Cheng S, Vargas G et al (2012) Expression of Ki-67, PTTG1, FGFR4, and SSTR 2, 3, and 5 in nonfunctioning pituitary adenomas: a high throughput TMA, immunohistochemical study. J Clin Endocrinol Metab 97:1745–1751. https://doi.org/10.1210/jc.2011-3163 CrossRefPubMed

66.

Ben-Shlomo A, Melmed S (2008) Somatostatin agonists for treatment of acromegaly. Mol Cell Endocrinol 286:192–198. https://doi.org/10.1016/j.mce.2007.11.024 CrossRefPubMed

67.

Florio T, Thellung S, Arena S et al (1999) Somatostatin and its analog lanreotide inhibit the proliferation of dispersed human non-functioning pituitary adenoma cells in vitro. Eur J Endocrinol 141:396–408CrossRefPubMed

68.

Pawlikowski M, Lawnicka H, Pisarek H, Kunert-Radek J, Radek M, Culler MD (2007) Effects of somatostatin-14 and the receptor-specific somatostatin analogs on chromogranin A and alphasubunit (alpha-SU) release from “clinically nonfunctioning” pituitary adenoma cells incubated in vitro. J Physiol Pharmacol 58:179–188PubMed

69.

Padova H, Rubinfeld H, Hadani M et al (2008) Effects of selective somatostatin analogs and cortistatin on cell viability in cultured human non-functioning pituitary adenomas. Mol Cell Endocrinol 286:214–218. https://doi.org/10.1016/j.mce.2007.12.011 CrossRefPubMed

70.

Fusco A, Giampietro A, Bianchi A et al (2012) Treatment with octreotide LAR in clinically non-functioning pituitary adenoma: results from a case-control study. Pituitary 15:571–578. https://doi.org/10.1007/s11102-011-0370-8 CrossRefPubMed

71.

Schmid HA, Schoeffter P (2004) Functional activity of the multiligand analog SOM230 at human recombinant somatostatin receptor subtypes supports its usefulness in neuroendocrine tumors. Neuroendocrinology 80:47–50. https://doi.org/10.1159/000080741 CrossRefPubMed

72.

Silverstein JM (2016) Hyperglycemia induced by pasireotide in patients with Cushing’s disease or acromegaly. Pituitary 19:536–543. https://doi.org/10.1007/s11102-016-0734-1 CrossRefPubMedPubMedCentral

73.

Baragli A, Alturaihi H, Watt HL, Abdallah A, Kumar U (2007) Heterooligomerization of human dopamine receptor 2 and somatostatin receptor 2 Co-immunoprecipitation and fluorescence resonance energy transfer analysis. Cell Signal 19:2304–2316. https://doi.org/10.1016/j.cellsig.2007.07.007 CrossRefPubMed

74.

Chatzellis E, Alexandraki KI, Androulakis II, Kaltsas G (2015) Aggressive pituitary tumors. Neuroendocrinology 101:87–104. https://doi.org/10.1159/000371806 CrossRefPubMed

75.

Raverot G, Burman P, McCormack A et al (2018) European Society of Endocrinology Clinical Practice Guidelines for the management of aggressive pituitary tumours and carcinomas. Eur J Endocrinol 178:G1–G24. https://doi.org/10.1530/EJE-17-0796 CrossRefPubMed

76.

Halevy C, Whitelaw BC (2017) How effective is temozolomide for treating pituitary tumours and when should it be used? Pituitary 20:261–266. https://doi.org/10.1007/s11102-016-0745-y CrossRefPubMed

77.

Lasolle H, Cortet C, Castinetti F et al (2017) Temozolomide treatment can improve overall survival in aggressive pituitary tumors and pituitary carcinomas. Eur J Endocrinol 176:769–777. https://doi.org/10.1530/EJE-16-0979 CrossRefPubMed

78.

Bengtsson D, Schroder HD, Andersen M et al (2015) Long-term outcome and MGMT as a predictive marker in 24 patients with atypical pituitary adenomas and pituitary carcinomas given treatment with temozolomide. J Clin Endocrinol Metab 100:1689–1698. https://doi.org/10.1210/jc.2014-4350 CrossRefPubMed

79.

McCormack AI, Wass JA, Grossman AB (2011) Aggressive pituitary tumours: the role of temozolomide and the assessment of MGMT status. Eur J Clin Investig 41:1133–1148. https://doi.org/10.1111/j.1365-2362.2011.02520.x CrossRef

80.

Stupp R, Mason WP, van den Bent MJ et al (2005) Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 352:987–996. https://doi.org/10.1056/NEJMoa043330 CrossRefPubMed

81.

Losa M, Bogazzi F, Cannavo S et al (2016) Temozolomide therapy in patients with aggressive pituitary adenomas or carcinomas. J Neuro-Oncol 126:519–525. https://doi.org/10.1007/s11060-015-1991-y CrossRef

82.

Hirohata T, Asano K, Ogawa Y et al (2013) DNA mismatch repair protein (MSH6) correlated with the responses of atypical pituitary adenomas and pituitary carcinomas to temozolomide: the national cooperative study by the Japan Society for Hypothalamic and Pituitary Tumors. J Clin Endocrinol Metab 98:1130–1136. https://doi.org/10.1210/jc.2012-2924 CrossRefPubMed

83.

Raverot G, Sturm N, de Fraipont F et al (2010) Temozolomide treatment in aggressive pituitary tumors and pituitary carcinomas: a French multicenter experience. J Clin Endocrinol Metab 95:4592–4599. https://doi.org/10.1210/jc.2010-0644 CrossRefPubMed

84.

Raverot G, Castinetti F, Jouanneau E et al (2012) Pituitary carcinomas and aggressive pituitary tumours: merits and pitfalls of temozolomide treatment. Clin Endocrinol 76:769–775. https://doi.org/10.1111/j.1365-2265.2012.04381.x CrossRef

85.

Keane F, Egan AM, Navin P, Brett F, Dennedy MC (2016) Gonadotropin-releasing hormone agonist-induced pituitary apoplexy. Endocrinol Diabetes Metab Case Rep 2016:160021. https://doi.org/10.1530/EDM-16-0021 CrossRefPubMedPubMedCentral

86.

Komor J, Reubi JC, Christ ER (2014) Peptide receptor radionuclide therapy in a patient with disabling non-functioning pituitary adenoma. Pituitary 17:227–231. https://doi.org/10.1007/s11102-013-0494-0 CrossRefPubMed

87.

Maclean J, Aldridge M, Bomanji J, Short S, Fersht N (2014) Peptide receptor radionuclide therapy for aggressive atypical pituitary adenoma/carcinoma: variable clinical response in preliminary evaluation. Pituitary 17:530–538. https://doi.org/10.1007/s11102-013-0540-y CrossRefPubMed

88.

Liu X, Ma S, Dai C et al (2013) Antiproliferative, antiinvasive, and proapoptotic activity of folate receptor alpha-targeted liposomal doxorubicin in nonfunctional pituitary adenoma cells. Endocrinology 154:1414–1423. https://doi.org/10.1210/en.2012-2128 CrossRefPubMed

89.

Zatelli MC, Minoia M, Filieri C et al (2010) Effect of everolimus on cell viability in nonfunctioning pituitary adenomas. J Clin Endocrinol Metab 95:968–976. https://doi.org/10.1210/jc.2009-1641 CrossRefPubMed

90.

Lee M, Wiedemann T, Gross C et al (2015) Targeting PI3K/mTOR signaling displays potent antitumor efficacy against nonfunctioning pituitary adenomas. Clin Cancer Res 21:3204–3215. https://doi.org/10.1158/1078-0432.CCR-15-0288 CrossRefPubMed

91.

Sherlock M, Ayuk J, Tomlinson JW et al (2010) Mortality in patients with pituitary disease. Endocr Rev 31:301–342. https://doi.org/10.1210/er.2009-0033 CrossRefPubMed

Titel: Medical therapy for non-functioning pituitary tumors—a critical approach
verfasst von: Metaxia Tampourlou
Olga Karapanou
Dimitra A. Vassiliadi
Stylianos Tsagarakis
Publikationsdatum: 01.06.2019
Verlag: Springer International Publishing
Erschienen in: Hormones / Ausgabe 2/2019
Print ISSN: 1109-3099
Elektronische ISSN: 2520-8721
DOI: https://doi.org/10.1007/s42000-018-0070-0

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