Refractory Lactotroph Adenomas

Sandrine A. Urwyler, Niki Karavitaki*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

A small subset of lactotroph adenomas is resistant to dopamine agonists (DA) and can also demonstrate aggressive or even malignant behavior. The implicated mechanisms are not clearly defined. Management can be challenging and requires a multidisciplinary approach. In DA resistant prolactinomas, switching to another DA could be the first option to consider. Further strategies include surgery and radiotherapy used alone or in combination. In cases of aggressive or malignant prolactinomas, temozolomide could be offered. Immune checkpoint inhibitors have been also recently proposed as an alternative approach. The place of other treatments (e.g., metformin, selective estrogen modulators, somatostatin analogues, tyrosine kinase inhibitors, inhibitors of mammalian target of rapamycin and peptide radio-receptor therapy) remains to be carefully assessed.
Original languageEnglish
Number of pages5
JournalPituitary
Early online date16 Mar 2023
DOIs
Publication statusE-pub ahead of print - 16 Mar 2023

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