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Pituitary adenoma current therapy

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https://www.readbyqxmd.com/read/29589552/evaluation-and-management-of-the-child-with-thyrotoxicosis
#1
Alexander K C Leung, Alexander A C Leung
BACKGROUND: Uncontrolled thyrotoxicosis, especially in early infancy, may cause irreversible damage to the central nervous system as well as profound effects on the function of many organs. Thyrotoxicosis has multiple etiologies and treatment depends on the underlying etiology. An accurate diagnosis is essential so that appropriate treatment can be initiated without undue delay. OBJECTIVE: To review in depth the evaluation, diagnosis, and treatment of children with thyrotoxicosis...
March 26, 2018: Recent Patents on Endocrine, Metabolic & Immune Drug Discovery
https://www.readbyqxmd.com/read/29535142/treatment-of-pituitary-tumors-with-temozolomide-an-update
#2
Luis V Syro, Fabio Rotondo, Leon D Ortiz, Kalman Kovacs
Temozolomide is an alkylating chemotherapeutic agent used in malignant neuroendocrine neoplasia, melanoma, brain metastases, and an essential component of adjuvant therapy in the treatment of glioblastoma multiforme and anaplastic astrocytoma. Since 2006 it has been used for the treatment of pituitary carcinomas and aggressive pituitary adenomas. Here, we discuss the current indications and results of temozolomide therapy in pituitary tumors, as well as frequently asked questions regarding temozolomide treatment, duration of therapy, dosage, tumor recurrence, and resistance...
March 13, 2018: Endocrine-related Cancer
https://www.readbyqxmd.com/read/29361932/efficacy-of-combined-treatment-with-pasireotide-pegvisomant-and-cabergoline-in-an-acromegalic-patient-resistant-to-other-treatments-a-case-report
#3
A Ciresi, S Radellini, V Guarnotta, C Giordano
BACKGROUND: The approach to acromegalic patients with persistent acromegaly after surgery and inadequate response to first-generation somatostatin receptor ligands (SRLs) should be strictly tailored. Current options include new pituitary surgery and/or radiosurgery, or alternative medical treatment with SRLs high dose regimens, pegvisomant (PEG) as monotherapy, or combined therapy with the addition of PEG or cabergoline to SRLs. A new pharmacological approach includes pasireotide, a second-generation SRL approved for patients who do not adequately respond to surgery and/or for whom surgery is not an option...
January 24, 2018: BMC Endocrine Disorders
https://www.readbyqxmd.com/read/28867316/endoscopic-endonasal-surgery-for-treatment-of-pituitary-apoplexy-16-years-of-experience-in-a-specialized-pituitary-center
#4
Jackson A Gondim, Lucas Alverne F de Albuquerque, Joao Paulo Almeida, Tania Bulcao, Erika Gomes, Michele Schops, Raquel Vasconcelos, Flora da Paz, Sergio Botelho Guimarães
OBJECTIVE: Symptomatic pituitary apoplexy is a rare but life-threatening condition caused by sudden hemorrhage or infarction of a pituitary adenoma. In the current study, we aim to evaluate the clinical presentation, management, and clinical outcomes in a cohort of patients who were treated for this condition in our center in the last 16 years. METHODS: We performed a retrospective analysis of all patients who underwent endoscopic endonasal surgery for treatment of symptomatic pituitary apoplexy between 2001 and 2016 in our center...
December 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28685507/recent-progress-in-the-medical-therapy-of-pituitary-tumors
#5
REVIEW
Fabienne Langlois, Shirley McCartney, Maria Fleseriu
Management of pituitary tumors is multidisciplinary, with medical therapy playing an increasingly important role. With the exception of prolactin-secreting tumors, surgery is still considered the first-line treatment for the majority of pituitary adenomas. However, medical/pharmacological therapy plays an important role in controlling hormone-producing pituitary adenomas, especially for patients with acromegaly and Cushing disease (CD). In the case of non-functioning pituitary adenomas (NFAs), pharmacological therapy plays a minor role, the main objective of which is to reduce tumor growth, but this role requires further studies...
June 2017: Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28660317/ischemic-stroke-after-radiation-therapy-for-pituitary-adenomas-a-systematic-review
#6
REVIEW
A van Westrhenen, I S Muskens, J J C Verhoeff, T R S Smith, M L D Broekman
Radiation therapy is widely used for the treatment of residual and recurrent pituitary adenomas and proved to effectively control tumor growth. However, it is suggested that this treatment might result in an increased risk of ischemic stroke. This review aims to evaluate the radiotherapy-related risk of stroke in pituitary adenoma patients. PubMed and Embase databases were systematically searched for current literature on ischemic stroke risk after radiotherapy in pituitary adenoma, in accordance with the PRISMA statement...
October 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/28629376/radiation-therapy-for-older-patients-with-brain-tumors
#7
REVIEW
Giuseppe Minniti, Andrea Riccardo Filippi, Mattia Falchetto Osti, Umberto Ricardi
The incidence of brain tumors in the elderly population has increased over the last few decades. Current treatment includes surgery, radiotherapy and chemotherapy, but the optimal management of older patients with brain tumors remains a matter of debate, since aggressive radiation treatments in this population may be associated with high risks of neurological toxicity and deterioration of quality of life. For such patients, a careful clinical status assessment is mandatory both for clinical decision making and for designing randomized trials to adequately evaluate the optimal combination of radiotherapy and chemotherapy...
June 19, 2017: Radiation Oncology
https://www.readbyqxmd.com/read/28472827/3d-volumetric-measurements-of-gh-secreting-adenomas-correlate-with-baseline-pituitary-function-initial-surgery-success-rate-and-disease-control
#8
Amit Tirosh, Georgios Z Papadakis, Prashant Chittiboina, Charalampos Lyssikatos, Elena Belyavskaya, Meg Keil, Maya B Lodish, Constantine A Stratakis
There is scarce data on the clinical utility of volume measurement for growth hormone (GH)-secreting pituitary adenomas. The current study objective was to assess the association between pituitary adenoma volumes and baseline endocrine evaluation, initial surgical success rate, and disease control among patients with acromegaly. A retrospective cohort study was conducted at a clinical research center including patients with acromegaly due to GH-secreting pituitary adenomas. Baseline hormonal evaluation and adenoma characteristics according to MRI were collected...
May 4, 2017: Hormone and Metabolic Research, Hormon- und Stoffwechselforschung, Hormones et Métabolisme
https://www.readbyqxmd.com/read/28468768/management-of-endocrine-disease-present-and-future-perspectives-for-medical-therapy-of-nonfunctioning-pituitary-adenomas
#9
REVIEW
Yona Greenman
In contrast to the clear indication for surgical treatment in symptomatic patients with clinically nonfunctioning pituitary adenomas (NFPA), there are no randomized controlled studies comparing therapeutic strategies such as watchful waiting, irradiation or medical therapy for the management of NFPA after surgery. Further, no medical therapy is currently approved for the treatment of NFPA. In this review, we summarize accumulating data on medications currently approved for secreting pituitary adenomas, used off-label in patients with NFPA...
September 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28377801/current-best-practice-in-the-management-of-patients-after-pituitary-surgery
#10
REVIEW
Alessandro Prete, Salvatore Maria Corsello, Roberto Salvatori
Sellar and parasellar masses are a common finding, and most of them are treated surgically via transsphenoidal approach. This type of surgery has revolutionized the approach to several hypothalamic-pituitary diseases and is usually effective, and well-tolerated by the patient. However, given the complex anatomy and high density of glandular, neurological and vascular structures in a confined space, transsphenoidal surgery harbors a substantial risk of complications. Hypopituitarism is one of the most frequent sequelae, with central adrenal insufficiency being the deficit that requires a timely diagnosis and treatment...
March 2017: Therapeutic Advances in Endocrinology and Metabolism
https://www.readbyqxmd.com/read/28089836/delayed-cerebrospinal-fluid-rhinorrhea-after-gamma-knife-radiosurgery-with-or-without-preceding-transsphenoidal-resection-for-pituitary-pathology
#11
Avital Perry, Christopher S Graffeo, William R Copeland, Kathryn M Van Abel, Matthew L Carlson, Bruce E Pollock, Michael J Link
BACKGROUND: Skull base cerebrospinal fluid (CSF) leak after gamma knife radiosurgery (GKRS) is a very rare complication. In patients who were treated with both GKRS and transsphenoidal resection (TSR) for pituitary lesions, early CSF leak occurs at a comparable rate with the general TSR population (4%). Delayed CSF leak occurring more than a year after TSR, GKRS, or dual therapy is exceedingly rare. METHODS: Retrospective chart review and review of the literature...
April 2017: World Neurosurgery
https://www.readbyqxmd.com/read/27894193/currently-used-and-investigational-drugs-for-cushing%C3%A2-s-disease
#12
REVIEW
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...
January 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/27893664/genetic-aspects-of-pituitary-carcinoma-a-systematic-review
#13
REVIEW
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
#14
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
#15
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
#16
REVIEW
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
#17
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
#18
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 downregulate, 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...
2017: Neuroendocrinology
https://www.readbyqxmd.com/read/27454103/therapeutic-compounds-for-cushing-s-syndrome-a-patent-review-2012-2016
#19
REVIEW
Li Ma, Lina Yin, Qingzhong Hu
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...
November 2016: Expert Opinion on Therapeutic Patents
https://www.readbyqxmd.com/read/27352098/current-and-future-medical-treatments-for-patients-with-acromegaly
#20
REVIEW
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
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