Novel imaging techniques in refractory pituitary adenomas

MacFarlane, James; Huynh, K A; Powlson, Andrew S; Kolias, Angelos; Scoffings, Daniel; Mendichovszky, Iosif; Cheow, Heok; Bashari, Waiel; Jones, Jeremy; Gillett, Daniel; Koulouri, Olympia; Gurnell, Mark

doi:10.1007/s11102-023-01304-9

Cited by 3 publications

(1 citation statement)

References 22 publications

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“…Absence of SSTRs and expression of molecular markers of aggressiveness in surgical pituitary tissue are strongly identified as markers of expected poor response to fgSRLs (statement 4.4-4.5). This is of great interest, since it implies that experts rely substantially on novel pathological techniques, recently found not to be routinely available also in Pituitary Tumor Centers of Excellence [32][33][34].…”

Section: Incidence Definition Of Resistance To Therapy With Fgsrls An...mentioning

confidence: 99%

Insights from an Italian Delphi panel: exploring resistance to first-generation somatostatin receptor ligands and guiding second-line medical therapies in acromegaly management

Grottoli,

Maffei,

Tresoldi

et al. 2024

J Endocrinol Invest

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Purpose First-line medical therapy for acromegaly management includes first-generation somatostatin receptor ligands (fgSRLs), but resistance limits their use. Despite international guidelines, the choice of second-line therapy is debated. Methods We aim to discuss resistance to fgSRLs, identify second-line therapy determinants and assess glycemia’s impact to provide valuable insights for acromegaly management in clinical practice. A group of Italian endocrinologists expert in the pituitary field participated in a two-round Delphi panel between July and September 2023. The Delphi questionnaire encompassed a total of 75 statements categorized into three sections: resistance to fgSRLs therapy and predictors of response; determinants for the selection of second-line therapy; the role of glycemia in the therapeutic management. The statements were rated on a 6-point Likert scale. Results Fifty-nine (79%) statements reached a consensus. IGF-1 levels resulted central for evaluating resistance to fgSRLs, that should be defined considering also symptomatic clinical response, degree of tumor shrinkage and complications, using clinician- and patient-reported outcome tools available. Factors to be evaluated for the choice of second-line medical therapy are hyperglycemia—that should be managed as in non-acromegalic patients—tumor remnant, resistant headache and compliance. Costs do not represent a main determinant in the choice of second-line medical treatment. Conclusion The experts agreed on a holistic management approach to acromegaly. It is therefore necessary to choose currently available highly effective second-line medical treatment (pegvisomant and pasireotide) based on the characteristics of the patients.

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Section: Incidence Definition Of Resistance To Therapy With Fgsrls An...mentioning

confidence: 99%

Insights from an Italian Delphi panel: exploring resistance to first-generation somatostatin receptor ligands and guiding second-line medical therapies in acromegaly management

Grottoli,

Maffei,

Tresoldi

et al. 2024

J Endocrinol Invest

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Refractory pituitary adenomas: preface

Geer

2023

Pituitary

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Everolimus in pituitary tumor: a review of preclinical and clinical evidence

Yao,

Chen

2024

Front. Endocrinol.

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Although pituitary tumors (PTs) are mostly benign, some PTs are characterized by low surgical resection rates, high recurrence rates, and poor response to conventional treatments and profoundly affect patients’ quality of life. Everolimus (EVE) is the only FDA-approved mTOR inhibitor, which can be used for oral treatment. It effectively inhibits tumor cell proliferation and angiogenesis. It has been administered for various neuroendocrine tumors of the digestive tract, lungs, and pancreas. EVE not only suppresses the growth and proliferation of APT cells but also enhances their sensitivity to radiotherapy and chemotherapy. This review introduces the role of the PI3K/AKT/mTOR pathway in the development of APTs, comprehensively explores the current status of preclinical and clinical research of EVE in APTs, and discusses the blood-brain barrier permeability and safety of EVE.

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Novel imaging techniques in refractory pituitary adenomas

Cited by 3 publications

References 22 publications

Insights from an Italian Delphi panel: exploring resistance to first-generation somatostatin receptor ligands and guiding second-line medical therapies in acromegaly management

Insights from an Italian Delphi panel: exploring resistance to first-generation somatostatin receptor ligands and guiding second-line medical therapies in acromegaly management

Refractory pituitary adenomas: preface

Everolimus in pituitary tumor: a review of preclinical and clinical evidence

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