Medical Treatment of Prolactinomas

Molitch, Mark E.

doi:10.1016/s0889-8529(05)70061-x

Cited by 152 publications

(77 citation statements)

References 147 publications

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“…3,4,19,20 The results of the current study confirmed that the PRL level shows a good correlation with tumor size and also confirmed that both PRL level and tumor size are correlated with age. The …”

Section: Discussionsupporting

confidence: 84%

Clinicopathologic study of 123 cases of prolactin‐secreting pituitary adenomas with special reference to multihormone production and clonality of the adenomas

Ikeda

Yoshimoto

2002

Cancer

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BACKGROUNDProlactinoma is the most invasive type of pituitary adenoma and is generally believed to be well‐differentiated adenoma and to produce only prolactin (PRL). The factors related to the various biologic behaviors occurring in patients of different ages and sexes await clarification. Since different immunophenotypes of adenoma may show different biologic behaviors and responses to medical agents, the authors examined hormone production and tried to clarify the clonality of plurihormonal prolactinoma.METHODSClinicopathologic factors were studied in 123 patients with prolactinomas (40 males and 83 females). The specimens were fixed in either 10% neutral buffered formalin or 70% alcohol and used for light microscopy. Alcohol‐fixed tissue was used to extract DNA from 26 samples obtained from female patients for human androgen receptor gene (HUMARA) assay.RESULTSSixty one cases (50%) were pure prolactinoma and 62 cases (50%) were plurihormonal prolactinoma. Spearman rank correlation analysis revealed a significant relationship between age and serum PRL level (P = 0.0002), age and tumor volume (P < 0.0001), and tumor volume and serum PRL level (P < 0.0001). Multiple regression analysis showed a significant correlation only between tumor volume and serum PRL level. The Mann‐Whitney U test revealed that prolactinomas associated with higher PRL levels, larger adenomas, and higher ages were significantly more invasive to the cavernous sinus and that male patients had significantly higher PRL levels and larger adenomas. The HUMARA assay disclosed that 11 of 13 plurihormonal prolactinomas (85%) were compatible with monoclonal origin.CONCLUSIONSThe current results suggest that not only can various hormones other than PRL be secreted by prolactinoma, but also that most multihormone‐producing prolactinomas are monoclonal in origin. Cancer 2002;95:258–66. © 2002 American Cancer Society.DOI 10.1002/cncr.10676

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Section: Discussionsupporting

confidence: 84%

Clinicopathologic study of 123 cases of prolactin‐secreting pituitary adenomas with special reference to multihormone production and clonality of the adenomas

Ikeda

Yoshimoto

2002

Cancer

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“…Radiotherapy rarely results in the restoration of normal serum prolactin concentrations and therefore is generally not considered as a primary treatment for prolactinomas. For this reason, it is reserved for patients with tumors that are growing despite medical or surgical treatment (10). Themaintherapeutic advancein the management of hyperprolactinemia has been the development of effective drugs.…”

Section: Introductionmentioning

confidence: 99%

“…Someadverse effects, such as headache, dizziness and nausea, can not be tolerated by about 10% of patients. In addition, bromocriptine is not sufficient to normalize hyperprolactinemia in some patients (10,12). For these reasons, several new dopamine-agonist drugs have been developed, including lysuride, metergoline, terguride and pergolide.…”

Section: Introductionmentioning

confidence: 99%

Comparison of the Effects of Cabergoline and Bromocriptine on Prolactin Levels in Hyperprolactinemic Patients.

et al. 2001

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Objective It is well knownthat bromocriptine has a suppressive effect on the prolactin release in hyperprolactinemic patients. But it also has someadverse effects. The new, long-acting dopaminergic drug, cabergoline, has been reported to be an effective agent in these patients. However, there are relatively few reports comparing the beneficial and adverse effects of these drugs in the treatment of hyperprolactinemic patients. Therefore, here we studied and compared the efficacy and tolerability of cabergoline with bromocriptine in hyperprolactinemic patients.Patients Seventeen patients (7 with microprolactinoma, 4 with macroprolactinoma, 6 with idiopathic hyperprolactinemia) were given bromocriptine at a dose of 2.5 mg (or 5 mgfor macroprolactinomas) twice daily, and 17 patients (8 with microprolactinoma, 4 with macroprolactinoma, 5 with idiopathic hyperprolactinemia) were given cabergoline at a dose of 0.5 mg twice weekly for 12 weeks. Results At the end of the study, the prolactin reduction was significantly greater in the cabergoline group than in the bromocriptine group (-93 vs. -87.5%, respectively, p<0.05). Normalization of prolactin levels was achieved in 10 of 17 patients (59%) in the bromocriptine group, and in 14 of 17 patients (82%) in the cabergoline group (p=0.13).Twopatients (50%) with macroprolactinoma in the bromocriptine group and three patients (75%) with macroprolactinoma in the cabergoline group demonstrated a normalization of their serum prolactin levels. Adverse events were noted in 53%of bromocriptine patients and in 12% of cabergoline patients (p<0.01). Conclusion These data indicate that cabergoline is a very effective agent for lowering the prolactin levels in hyperprolactinemic patients and that it appears to offer considerable advantage over bromocriptine in terms of efficacy and tolerability.

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“…Bromocriptine was the first dopamine agonist in worldwide clinical use for treatment of hyperprolactinemia and prolactinomas (1). It can normalize elevated PRL levels in 80-90% of prolactinoma patients (1) and thereby restore normal gonadal function, cease galactorrhea, and recover visual disturbance in a majority of patients.…”

mentioning

confidence: 99%

“…An additional clinical dilemma in the treatment of prolactinomas is the fact that 5-10% of patients are resistant to medical therapy (1). However, cabergoline is reported to work well in these resistant cases as well (6)(7)(8) …”

mentioning

confidence: 99%

Cabergoline, a Hopeful Medicine for Prolactinomas and Non-tumoral Hyperprolactinemia

Miki

2001

Intern. Med.

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Medical Treatment of Prolactinomas

Cited by 152 publications

References 147 publications

Clinicopathologic study of 123 cases of prolactin‐secreting pituitary adenomas with special reference to multihormone production and clonality of the adenomas

Clinicopathologic study of 123 cases of prolactin‐secreting pituitary adenomas with special reference to multihormone production and clonality of the adenomas

Comparison of the Effects of Cabergoline and Bromocriptine on Prolactin Levels in Hyperprolactinemic Patients.

Cabergoline, a Hopeful Medicine for Prolactinomas and Non-tumoral Hyperprolactinemia

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