Successful management of octreotide-insensitive thyrotropin-secreting pituitary adenoma with bromocriptine and surgery

Yang, Chengxian; Wu, Huanwen; Wang, Jing; Hu, Ming; Xing, Xiaoping; Bao, Xinjie; Wang, Renzhi

doi:10.1097/md.0000000000008017

Cited by 8 publications

(7 citation statements)

References 29 publications

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“…Here, bromocriptine combined with TEM was used as a basic treatment for rPA after tumor resection. Bromocriptine, a derivative of ergometrine, is a specific allosteric hypothalamic and pituitary dopamine receptor agonist that acts directly on the adenohypophysis to inhibit PRL secretion and facilitate GH release [ 15 ]. It has been reported that bromocriptine is effective in the treatment of hyperprolactinemia with prolactinoma, as bromocriptine effectively regulates prolactin, reestablishes gonadal function, and reduces tumor volume [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Chemotherapy of Capecitabine plus Temozolomide for Refractory Pituitary Adenoma after Tumor Resection and Its Impact on Serum Prolactin, IGF-1, and Growth Hormone

Wang

et al. 2022

Journal of Oncology

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Objective. To investigate the efficiency of capecitabine (CAP) plus temozolomide (TEM) in refractory pituitary adenoma after tumor resection and its impact on serum prolactin (PRL), insulin-like growth factor 1 (IGF-1), and growth hormone (GH) levels. Methods. From January 2017 to January 2020, 80 patients assessed for eligibility receiving transsphenoidal tumor resection for refractory pituitary adenoma in the Department of Neurosurgery of our hospital were recruited. They were randomly distributed at a ratio of 1 : 1 via the random number table method to receive either bromocriptine and TEM (control group) or bromocriptine plus combination chemotherapy of TEM and CAP (study group). The two groups were compared in terms of clinical efficacy and serum levels of PRL, IGF-1, and GH. Results. The objective response rate (ORR) was 87.50% and 67.50% in the study group and the control group, respectively P = 0.032 . Before treatment, two groups had similar levels of PRL, IGF-1, and GH. After treatment, PRL levels in the study group were lower than that in the control group (278.35 ± 39.25 versus 326.35 ± 42.45, P < 0.001 ). Compared with the control group, IGF-1 levels in the study group were also lower (311.78 ± 28.82 versus 364.35 ± 31.35, P < 0.001 ). The study group presented markedly lower levels of thyroid-stimulating hormone (TSH) and higher serum levels of free thyroxine-4 (FT-4) and adrenocorticotropic hormone (ACTH) versus the control group P < 0.05 . The incidence of adverse events was comparable between the study group (30.0%) and the control group (22.5%) P > 0.05 . All eligible patients had similar progression-free survival (PFS) after chemotherapy. Conclusion. For patients with refractory pituitary adenoma, the combination chemotherapy of CAP and TEM significantly improves clinical outcomes and corrects hormonal disturbances, with a good safety profile, but its long-term efficacy requires further investigation.

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Section: Discussionmentioning

confidence: 99%

Chemotherapy of Capecitabine plus Temozolomide for Refractory Pituitary Adenoma after Tumor Resection and Its Impact on Serum Prolactin, IGF-1, and Growth Hormone

Wang

et al. 2022

Journal of Oncology

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“…DAs may be used as a second‐line medical therapy to facilitate euthyroid states preoperatively if SST agonists are not tolerated, and can also be used to treat TSHomas if surgery is contraindicated, although the reported benefits have been modest. The successful preoperative use of bromocriptine in a case of a TSHoma not responsive to SST analogues has been reported, 109 and there are scattered case reports of hormonal control achieved with DAs when surgery is contraindicated 110,111 . However, in a case series by Socin and colleagues describing the use of DAs in 7 TSHoma patients, a response was only observed in a single subject whose tumour cosecreted prolactin 104 .…”

Section: Dopamine Agonists For the Treatment Of Thyroid Stimulating H...mentioning

confidence: 99%

Dopamine agonists for the treatment of pituitary tumours: From ergot extracts to next generation therapies

Wexler

Page-Wilson

2023

Brit J Clinical Pharma

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They are the established first-line treatment for prolactinomas which express high levels of D2 receptors. Growing data support their use as an adjuvant treatment option for other pituitary tumours including growth hormone, adrenocorticotrophic hormones, thyroid hormone secreting adenomas and nonfunctional pituitary tumours, all of which have been shown to express D2 receptors as well, albeit to varying extents. For those pituitary tumours inadequately treated by dopamine agonist alone, combined agonism of D2 and somatostatin receptors represent a new frontier in clinical development. Here we review the development and role of dopamine agonist for the treatment of prolactinomas, the literature supporting their adjuvant use for the treatment of all other pituitary tumours, and recent progress in the development of the next generation of chimeric compounds that target D2 and other receptor subtypes highly expressed on pituitary tumour cells.

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“…88 Dopamine agonists may be used as second-line medical therapy to facilitate euthyroid states pre-operatively if somatostatin agonists are not tolerated, and can also be used to treat TSHomas if surgery is contraindicated, although the reported benefits have been modest. The successful pre-operative use of bromocriptine in a case of a TSHoma not responsive to somatostatin analogs has been reported, 98 and there are scattered case reports of hormonal control achieved with dopamine agonists when surgery is contraindicated. 99,100 However, in a case series by Socin and colleagues describing the use of dopamine agonists in seven TSHoma patients, a response was only observed in a single subject whose tumor cosecreted prolactin.…”

Section: Dopamine Agonist For the Treatment Of Tsh-secreting Adenomasmentioning

confidence: 99%

Dopamine Agonists for the Treatment of Pituitary Tumors: From Ergot Extracts to Next Generation Therapies

Wexler

Page-Wilson

2022

Preprint

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Dopamine agonists are a key tool in the therapeutic arsenal of endocrinologists worldwide. They exert their effects by binding to dopamine 2 (D2) receptors expressed by pituitary tumor cells, to modulate hormonal secretion and tumor size. They are the established first-line treatment for prolactinomas which express high levels of D2 receptors. Growing data supports their use as an adjuvant treatment option for other pituitary tumors including growth hormone, adrenocorticotrophic hormones, thyroid hormone secreting adenomas and non-functional pituitary tumors, all of which have been shown to express D2 receptors as well, albeit to varying extents. For those pituitary tumors inadequately treated by dopamine agonist alone, combined agonism of D2 and somatostatin receptors, represent a new frontier in clinical development. Here we review the development and role of dopamine agonist for the treatment of prolactinomas, the literature supporting their adjuvant use for the treatment of all other pituitary tumors, and recent progress in the development of the next generation of chimeric compounds that target D2 and other receptor subtypes highly expressed on pituitary tumor cells.

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Successful management of octreotide-insensitive thyrotropin-secreting pituitary adenoma with bromocriptine and surgery

Abstract: Attention should be paid to the role of dopamine agonists such as bromocriptine and cabergoline as adjuvant therapy for TSHomas that are insensitive to traditional medical treatment by somatostatin analogs.

Cited by 8 publications

References 29 publications

Chemotherapy of Capecitabine plus Temozolomide for Refractory Pituitary Adenoma after Tumor Resection and Its Impact on Serum Prolactin, IGF-1, and Growth Hormone

Chemotherapy of Capecitabine plus Temozolomide for Refractory Pituitary Adenoma after Tumor Resection and Its Impact on Serum Prolactin, IGF-1, and Growth Hormone

Dopamine agonists for the treatment of pituitary tumours: From ergot extracts to next generation therapies

Dopamine Agonists for the Treatment of Pituitary Tumors: From Ergot Extracts to Next Generation Therapies

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