Treatment Strategies for Dopamine Agonist-Resistant and Aggressive Prolactinomas: A Comprehensive Analysis of the Literature
Horm Metab Res 2021; 53: 413-424 DOI: 10.1055/a-1525-2131Despite most of the prolactinomas can be treated with endocrine therapy
and/or surgery, a significant percentage of these tumors can be
resistant to endocrine treatments and/or recur with prominent invasion
into the surrounding anatomical structures. Hence, clinical, pathological, and
molecular definitions of aggressive prolactinomas are important to guide for
classical and novel treatment modalities. In this review, we aimed to define
molecular endocrinological features of dopamine agonist-resistant and aggressive
prolactinomas for designing future multimodality treatments. Besides surgery,
temozolomide chemotherapy and radiotherapy, peptide receptor radionuclide
therapy, estrogen pathway modulators, progesterone antagonists or agonists,
mTOR/akt inhibitors, pasireotide, gefitinib/lapatinib,
everolimus, and metformin are tested in preclinical models, anecdotal cases, and
in small case series. Moreover, chorionic gonadotropin, gonadotropin releasing
hormone, TGFβ and PRDM2 may seem like possible future targets for
managing aggressive prolactinomas. Lastly, we discussed our management of a
unique prolactinoma case by asking which tumors’ proliferative index
(Ki67) increased from 5–6% to 26% in two subsequent
surgeries performed in a 2-year period, e...
Source: Hormone and Metabolic Research - Category: Endocrinology Authors: Sari, Ramazan Altinoz, Meric A. Ozlu, Eylem Burcu Kahraman Sav, Aydin Danyeli, Ayca Ersen Baskan, Ozdil Er, Ozlem Elmaci, Ilhan Tags: Review Source Type: research
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