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Pituitary adenoma current therapy

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https://www.readbyqxmd.com/read/27894193/currently-used-and-investigational-drugs-for-cushing%C3%A2-s-disease
#1
Denis Ciato, Aizhar G Mumbach, Marcelo Paez-Pereda, Günter K Stalla
Cushing's disease (CD) is caused by a corticotroph adenoma of the pituitary gland that secretes excess adrenocorticotropic hormone (ACTH) causing increased morbidity and mortality. Surgery is the treatment of choice, but is not always successful. Alternatives include radiotherapy, adrenal surgery, and pharmaceutical therapy. The latter is increasingly gaining momentum due to the recent development of compounds that reduce hypercortisolaemia or its symptoms, acting through different mechanisms. Areas covered: In this article, the authors provide a complete overview of the treatment options for Cushing´s disease, including adrenal-directed, tumor-targeted, and peripheral therapies that are currently used or in development, and discuss their potential advantages and limitations...
December 8, 2016: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/27893664/genetic-aspects-of-pituitary-carcinoma-a-systematic-review
#2
Zijiang Yang, Ting Zhang, Heng Gao
BACKGROUND: Pituitary carcinoma (PC) is a rare type of malignant intracranial neoplasm defined as distant metastasis of pituitary adenoma (PA). Although PC incidence is low because only 0.1% to 0.2% of PAs ultimately develop into PCs, the prognosis is poor and 66% of patients die within the first year. Existing therapeutic measures, including surgical removal, chemotherapy, and radiotherapy, have limited effectiveness. The lack of efficacy of current treatments is largely caused by the limited understanding of the molecular pathogenesis of PA and the malignant transformation to PC...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27551432/temozolomide-treatment-of-pituitary-carcinomas-and-atypical-adenomas-systematic-review-of-case-reports
#3
Yan Ji, Rachel Isaksson Vogel, Emil Lou
BACKGROUND: Pituitary carcinomas (PC) and atypical pituitary adenomas (APA) are rare variants of pituitary tumors for which no evidence-based treatment currently exists. We sought to determine whether temozolomide represents an effective chemotherapeutic option for patients with PC and APA. METHODS: A systematic review was performed using all published cases of PC and APA treated with temozolomide, and for which information on treatment regimen, clinical response, and survival could be identified...
September 2016: Neuro-oncology Practice
https://www.readbyqxmd.com/read/27517036/advancing-treatment-of-pituitary-adenomas-through-targeted-molecular-therapies-the-acromegaly-and-cushing-disease-paradigms
#4
REVIEW
Michael A Mooney, Elias D Simon, Andrew S Little
The current treatment of pituitary adenomas requires a balance of conservative management, surgical resection, and in select tumor types, molecular therapy. Acromegaly treatment is an evolving field where our understanding of molecular targets and drug therapies has improved treatment options for patients with excess growth hormone levels. We highlight the use of molecular therapies in this disease process and advances in this field, which may represent a paradigm shift for the future of pituitary adenoma treatment...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/27498733/primary-immune-thrombocytopenia-accompanied-by-pituitary-apoplexy
#5
Takahiro Tsuji, Hiromi Mochinaga, Hiroshi Yamasaki, Hiroyuki Tsuda
An 83-year-old woman was admitted to our hospital with a severe headache and purpura. She had previously been diagnosed with idiopathic thrombocytopenia purpura (ITP) and achieved complete remission with steroid therapy. Steroid therapy had been completed one week prior to the current admission. The recurrence of severe thrombocytopenia (<1.0×10(4) platelets/μl) was detected and a CT scan revealed pituitary hemorrhage without pituitary adenoma. She received steroid therapy combined with intravenous immunoglobulin, which resulted in the amelioration of ITP and improvements in the pituitary hemorrhage...
July 2016: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/27465333/over-expression-of-lrig1-suppresses-biological-function-of-pituitary-adenoma-via-attenuation-of-pi3k-akt-and-ras-raf-erk-pathways-in-vivo-and-in-vitro
#6
Shi-Qi Cheng, Heng-Yi Fan, Xin Xu, Wei-Wei Gao, Shi-Gang Lv, Min-Hua Ye, Miao-Jing Wu, Xiao-Li Shen, Zu-Jue Cheng, Xin-Gen Zhu, Yan Zhang
Pituitary adenomas (PAs) are well known as a common intracranial benign tumor, and a portion of PAs are refractory to current therapeutic methods. ErbB receptors family signaling pathway regulates the expression of PAs activation associated gene. Inhibition of epidermal growth factor receptor (EGFR) can inhibit proliferation of PAs. Leucine-rich repeats and immunoglobulin-like domains protein 1 ( LRIG1), a negative mediated gene of ErbB receptors family, plays a role in many tumors. However, there are seldom researches about the functional role of LRIG1 in PAs...
August 2016: Journal of Huazhong University of Science and Technology. Medical Sciences
https://www.readbyqxmd.com/read/27455094/somatostatin-receptor-expression-in-gh-secreting-pituitary-adenomas-treated-with-long-acting-somatostatin-analogues-in-combination-with-pegvisomant
#7
Sanne E Franck, Federico Gatto, Aart Jan van der Lely, Joseph A M J L Janssen, Alof H G Dallenga, A Paul Nagtegaal, Leo J Hofland, Sebastian J C M M Neggers
BACKGROUND: Growth hormone secreting pituitary adenomas (somatotroph adenoma) predominantly express somatostatin receptors (SSTRs) subtypes 2 and 5. Higher SSTR2 expression on somatotroph adenomas results in a better response to somatostatin analogues (SSAs), which preferentially bind, but also down regulate, SSTR2. The effect of the combined treatment with SSAs and the GH receptor antagonist pegvisomant (PEGV) on SSTR expression in somatotroph adenomas is currently unknown. AIM OF THE STUDY: To assess SSTR2 and SSTR5 expression in three groups of somatotroph adenomas: drug-naive, treated with long-acting (LA) SSA monotherapy, or LA-SSA/PEGV combination therapy before surgery...
July 25, 2016: Neuroendocrinology
https://www.readbyqxmd.com/read/27454103/therapeutic-compounds-for-cushing-s-syndrome-a-patent-review-2012-2016
#8
Li Ma, Lina Yin, Qingzhong Hu
INTRODUCTION: Endogenous Cushing's syndrome (CS) is a set of disorders caused by chronic exposure to excess glucocorticoids induced by neuroendocrine tumors in pituitary, adrenals, and infrequently other sites (ectopic ACTH syndrome). Due to various comorbidities, CS patients exhibit higher risks of cardiovascular diseases and thus increased mortality. Pharmaceutical therapy is an important constituent of treatment regimen. AREAS COVERED: Patents published since 2012 are reviewed, which claim therapeutic compounds interfering with ACTH secretion and down-stream signal transduction, inhibiting cortisol biosynthesis and antagonizing glucocorticoid receptors...
July 30, 2016: Expert Opinion on Therapeutic Patents
https://www.readbyqxmd.com/read/27352098/current-and-future-medical-treatments-for-patients-with-acromegaly
#9
Filippo Maffezzoni, Anna Maria Formenti, Gherardo Mazziotti, Stefano Frara, Andrea Giustina
INTRODUCTION: Acromegaly is a relatively rare condition of growth hormone (GH) excess associated with significant morbidity and, when left untreated, high mortality. Therapy for acromegaly is targeted at decreasing GH and insulin-like growth hormone 1 levels, ameliorating patients' symptoms and decreasing any local compressive effects of the pituitary adenoma. The therapeutic options for acromegaly include surgery, medical therapies (such as dopamine agonists, somatostatin receptor ligands and the GH receptor antagonist pegvisomant) and radiotherapy...
August 2016: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/27207245/therapy-of-endocrine-disease-surgery-in-microprolactinomas-effectiveness-and-risks-based-on-contemporary-literature
#10
REVIEW
Metaxia Tampourlou, Raluca Trifanescu, Alessandro Paluzzi, Shahzada K Ahmed, Niki Karavitaki
Microprolactinomas are the most common pituitary adenomas. In symptomatic patients, dopamine agonists are the first-line treatment of choice; when cabergoline is used, biochemical control rates between 85 and 93% have been reported. Long-term treatment is needed in most of the cases with compliance, patient convenience, and potential adverse effects representing areas requiring attention. Based on the literature published in the past 15 years, transsphenoidal surgery can lead to normal prolactin in the postoperative period in usually 71-100% of the cases with very low postoperative complication rates...
September 2016: European Journal of Endocrinology
https://www.readbyqxmd.com/read/27030224/-indications-and-future-perspectives-in-the-pharmacological-treatment-of-hypercortisolism
#11
Antonio Stigliano, Vincenzo Toscano
The hypercortisolism is a rare endocrine disease characterized by an autonomous steroid secretion or excessive adrenal stimulation by ACTH. the Surgical removal of the lesion directly responsible hypercortisolism represents the treatment of choice. When neurosurgery for pituitary adenoma is contraindicated, radiotherapy is candidate as the second line of therapy. Currently, the recent advances in medical therapy provide a viable alternative to surgery and radiotherapy, when these are not feasible or followed by relapses (present in more than one third of cases) of the underlying disease...
March 2016: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/26873451/acromegaly
#12
R Dineen, P M Stewart, M Sherlock
Acromegaly is a rare, chronic, progressive disease characterized by an excess secretion of growth hormone (GH) and increased circulating insulin-like growth factor 1 (IGF-1) concentrations. It is caused by a pituitary adenoma in the vast majority of cases. The clinical diagnosis, based on symptoms related to GH excess, is often delayed due to the insidious nature of the disease. Consequently, patients often have established systemic complications at diagnosis with increased morbidity and premature mortality...
February 12, 2016: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/26860936/clinical-impact-of-the-current-who-classification-of-pituitary-adenomas
#13
REVIEW
W Saeger, J Honegger, M Theodoropoulou, U J Knappe, C Schöfl, S Petersenn, R Buslei
WHO classifications should be used for comparing the results from different groups of pathologist and clinicians by standardized histopathological methods. Our present report describes the important parameters of pituitary adenoma pathology as demand of the WHO classification for correlation to endocrine data and prognosis. The combination of HE stain based structures with immunostainings for pituitary hormones allows subclassification of adenomas as the best method not only for correlations to clinical hyperfunctions but also for statements to the sensitivity of drug therapies (somatostatin analogs, dopamine agonists)...
June 2016: Endocrine Pathology
https://www.readbyqxmd.com/read/26722256/expression-of-agr2-in-pituitary-adenomas-and-its-association-with-tumor-aggressiveness
#14
Mamatemin Tohti, Junyang Li, Chiyuan Ma, Wanchun Li, Zhenfeng Lu, Yuebing Hu
The aim of the present study was to study the expression of anterior gradient 2 (AGR2) to determine its clinical significance in pituitary adenoma (PA), and to evaluate the potential effect of AGR2 on the diagnosis, therapy or prognosis of PA. Immunohistochemistry was performed to detect the expression of AGR2 in 117 PA tissue samples. Western blotting was performed to confirm the expression profile of AGR2 in different subtypes of PAs. The data showed that in 117 different histological subtypes of PA, 51.3% exhibited AGR2-positive expression...
November 2015: Oncology Letters
https://www.readbyqxmd.com/read/26664461/current-therapies-and-mortality-in-acromegaly
#15
REVIEW
S Găloiu, C Poiană
UNLABELLED: Acromegaly is a rare disease most frequently due to a GH secreting pituitary adenoma. Without an appropriate therapy, life of patients with acromegaly can be shortened with ten years. Pituitary surgery is usually the first line therapy for GH secreting pituitary adenomas. A meta-analysis proved that mortality is much lower in operated patients, even uncured, than the entire group of patients and is similar with the general population in patients with GH<1 μg/ L. For the patients with hypersecreting postoperative remnant tumor, those with low chance of surgical cure or with life-threatening comorbidities, medical therapies are available: somatostatin receptor analogues (SRA), dopamine agonists (DA) and GH receptor antagonists...
October 2015: Journal of Medicine and Life
https://www.readbyqxmd.com/read/26636388/growth-hormone-secreting-macroadenoma-of-the-pituitary-gland-successfully-treated-with-the-radiolabeled-somatostatin-analog-90-y-dotatate-case-report
#16
Joanna Waligórska-Stachura, Paweł Gut, Nadia Sawicka-Gutaj, Włodzimierz Liebert, Maria Gryczyńska, Daria Baszko-Błaszyk, Al Ricardo Blanco-Gangoo, Marek Ruchała
Pituitary tumors causing acromegaly are usually macroadenomas at the time of diagnosis, and they can grow aggressively, infiltrating surrounding tissues. Difficulty in achieving complete tumor removal at surgery can lead toward a strong tendency for recurrence, making it necessary to consider a means of treatment other than those currently used such as somatostatin analogs (SSAs), growth hormone (GH) receptor antagonist, surgical removal, and radiotherapy. The purpose of this paper is to describe a patient diagnosed with an aggressive, giant GH-secreting tumor refractory to medical therapy but ultimately treated with the radiolabeled somatostatin analog (90)Y-DOTATATE...
August 2016: Journal of Neurosurgery
https://www.readbyqxmd.com/read/26437214/limitations-of-current-approaches-for-the-treatment-of-acromegaly
#17
REVIEW
Michael H Shanik
OBJECTIVE: Acromegaly is a rare disease characterized by hypersecretion of growth hormone (GH), typically from a benign pituitary somatotroph adenoma, that leads to subsequent hypersecretion of insulin-like growth factor 1 (IGF-1). Patients with acromegaly have an increased risk of mortality and progressive worsening of comorbidities. Surgery, medical therapy, and radiotherapy are currently available treatment approaches for patients with acromegaly, with overall therapeutic goals of lowering GH levels and achieving normal IGF-1 levels, reducing tumor size, improving comorbidities, and minimizing mortality risk...
February 2016: Endocrine Practice
https://www.readbyqxmd.com/read/26347444/metabolic-abnormalities-in-pituitary-adenoma-patients-a-novel-therapeutic-target-and-prognostic-factor
#18
Xin Zheng, Song Li, Wei-Hua Zhang, Hui Yang
Metabolic abnormalities are common in cancers, and targeting metabolism is emerging as a novel therapeutic approach to cancer management. Pituitary adenoma (PA) is a type of benign tumor. Impairment of tumor cells' metabolism in PA seems not to be as apparent as that of other malignant tumor cells; however, aberrant hormone secretion is conspicuous in most PAs. Hormones have direct impacts on systemic metabolism, which in turn, may affect the progression of PA. Nowadays, conventional therapeutic strategies for PA do not include modalities of adjusting whole-body metabolism, which is most likely due to the current consideration of the aberrant whole-body metabolism of PA patients as a passive associated symptom and not involved in PA progression...
2015: Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy
https://www.readbyqxmd.com/read/26256063/update-on-prolactinomas-part-1-clinical-manifestations-and-diagnostic-challenges
#19
REVIEW
Anni Wong, Jean Anderson Eloy, William T Couldwell, James K Liu
The authors provide an update on the clinical manifestations and diagnostic challenges of prolactinomas. Prolactinomas are the most common pituitary adenoma seen in clinical practice. Secondary causes of hyperprolactinemia should be ruled out by assessment of the clinical history, including current medications, physical examination, pregnancy test, routine biochemical analysis with a thyroid function test, and neuroimaging, before a confirmatory diagnosis of prolactinoma is made. Prolactinomas are associated with endocrine dysfunction, affecting gonadal function and causing neurological deficits due to mass effect...
October 2015: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/26179179/optimal-management-of-non-functioning-pituitary-adenomas
#20
REVIEW
Yona Greenman, Naftali Stern
Transsphenoidal surgery is the treatment of choice for large non-functioning pituitary adenomas (NFPA) and symptomatic patients. The therapeutic strategies for the management of NFPA after surgery, i.e., watchful waiting, irradiation, or medical therapy have not been compared by randomized controlled trials. Slow re-growth is common, but the natural history of untreated tumors is variable. Conservative follow-up is associated with progression rates of over 40 %. Radiation is highly effective in preventing residual tumor growth, but has serious long-term side effects...
September 2015: Endocrine
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