TY - JOUR
T1 - Safety of growth hormone replacement in survivors of cancer and intra-cranial and pituitary tumours
T2 - A consensus statement
AU - Boguszewski, Margaret
AU - Boguszewski, Cesar L
AU - Chemaililly, Wassim
AU - Cohen, Laurie E
AU - Gebauer, Judith
AU - Higham, Claire E
AU - Hoffman, Andrew R
AU - Polak, Michel
AU - Yuen, Kevin C J
AU - Alos, Nathalie
AU - Antal, Zoltan
AU - Bidlingmaier, Martin
AU - Biller, Beverley M K
AU - Brabant, George
AU - Choong, Catherine S Y
AU - Cianfarani, Stefano
AU - Clayton, Peter
AU - Coutant, Regis
AU - Cardoso-Demartini, Adriane A
AU - Fernandez, Alberto
AU - Grimberg, Adda
AU - Guðmundsson, Kolbeinn
AU - Guevara-Aguirre, Jaime
AU - Ho, Ken
AU - Horikawa, Reiko
AU - Isidori, A M
AU - Jørgensen, Jens Otto Lunde
AU - Kamenicky, Peter
AU - Karavitaki, Niki
AU - Kopchick, John
AU - Lodish, Maya
AU - Luo, Xiaoping
AU - McCormack, Ann
AU - Meacham, Lillian
AU - Melmed, Shlomo
AU - Mostoufi Moab, Sogol
AU - Müller, Hermann
AU - Neggers, Sebastian
AU - Aguiar Oliveira, Manoel
AU - Ozono, Keiichi
AU - Pennisi, Patricia
AU - Popovic, Vera
AU - Radovick, Sally
AU - Savendahl, Lars
AU - Touraine, Philippe
AU - van Santen, Hanneke M
AU - Johannsson, Gudmundur
PY - 2022/4/21
Y1 - 2022/4/21
N2 - Growth hormone (GH) has been used for over 35 years, and its safety and efficacy has been studied extensively. Experimental studies showing the permissive role of GH/insulin-like growth factor 1 (IGF-I) in carcinogenesis have raised concerns regarding the safety of GH replacement in children and adults who have received treatment for cancer and those with intracranial and pituitary tumours. A consensus statement was produced to guide decision-making on GH replacement in children and adult survivors of cancer, in those treated for intracranial and pituitary tumours and in patients with increased cancer risk. With the support of the European Society of Endocrinology, the Growth Hormone Research Society convened a Workshop, where 55 international key opinion leaders representing 10 professional societies were invited to participate. This consensus statement utilized: (1) a critical review paper produced before the Workshop, (2) five plenary talks, (3) evidence-based comments from four breakout groups, and (4) discussions during report-back sessions. Current evidence reviewed from the proceedings from the Workshop does not support an association between GH replacement and primary tumour or cancer recurrence. The effect of GH replacement on secondary neoplasia risk is minor compared to host- and tumour treatment-related factors. There is no evidence for an association between GH replacement and increased mortality from cancer amongst GH-deficient childhood cancer survivors. Patients with pituitary tumour or craniopharyngioma remnants receiving GH replacement do not need to be treated or monitored differently than those not receiving GH. GH replacement might be considered in GH-deficient adult cancer survivors in remission after careful individual risk/benefit analysis. In children with cancer predisposition syndromes, GH treatment is generally contraindicated but may be considered cautiously in select patients.
AB - Growth hormone (GH) has been used for over 35 years, and its safety and efficacy has been studied extensively. Experimental studies showing the permissive role of GH/insulin-like growth factor 1 (IGF-I) in carcinogenesis have raised concerns regarding the safety of GH replacement in children and adults who have received treatment for cancer and those with intracranial and pituitary tumours. A consensus statement was produced to guide decision-making on GH replacement in children and adult survivors of cancer, in those treated for intracranial and pituitary tumours and in patients with increased cancer risk. With the support of the European Society of Endocrinology, the Growth Hormone Research Society convened a Workshop, where 55 international key opinion leaders representing 10 professional societies were invited to participate. This consensus statement utilized: (1) a critical review paper produced before the Workshop, (2) five plenary talks, (3) evidence-based comments from four breakout groups, and (4) discussions during report-back sessions. Current evidence reviewed from the proceedings from the Workshop does not support an association between GH replacement and primary tumour or cancer recurrence. The effect of GH replacement on secondary neoplasia risk is minor compared to host- and tumour treatment-related factors. There is no evidence for an association between GH replacement and increased mortality from cancer amongst GH-deficient childhood cancer survivors. Patients with pituitary tumour or craniopharyngioma remnants receiving GH replacement do not need to be treated or monitored differently than those not receiving GH. GH replacement might be considered in GH-deficient adult cancer survivors in remission after careful individual risk/benefit analysis. In children with cancer predisposition syndromes, GH treatment is generally contraindicated but may be considered cautiously in select patients.
KW - Adult
KW - Child
KW - Growth Hormone
KW - Human Growth Hormone/adverse effects
KW - Humans
KW - Insulin-Like Growth Factor I
KW - Neoplasm Recurrence, Local/chemically induced
KW - Pituitary Neoplasms/drug therapy
KW - Survivors
U2 - 10.1530/EJE-21-1186
DO - 10.1530/EJE-21-1186
M3 - Article
C2 - 35319491
SN - 0804-4643
VL - 186
SP - P35-P52
JO - European Journal of Endocrinology
JF - European Journal of Endocrinology
IS - 6
ER -