Aggressive Pituitary Tumor Therapies

What Works for Pituitary Tumors?

Pituitary gland part - Human brain in x-ray viewAn article published in the Expert Opinion on Pharmacotherapy journal in July 2011 reviewed treatments of aggressive pituitary tumors.  A pituitary tumor is classified as aggressive if it has a massive invasion of the surrounding anatomical structures; an aggressive tumor also has rapid growth.

Aggressive pituitary tumors are difficult to manage, and they are associated with poor prognosis.  This is because treatment options are limited—and aggressive tumors are, in general, unresponsive to therapy.  Therefore, the authors of the article “Therapy of aggressive pituitary tumors” evaluated the literature of the past 15 years, looking at treatment options for aggressive pituitary tumors.

Pituitary Tumor Treatments Examined
The review looked at the following therapies for aggressive pituitary tumors:

  • surgery
  • radiotherapy
  • medical treatment
  • promising therapeutic options

Effective Aggressive Pituitary Tumor Treatments
Surgery is the first-line option for aggressive pituitary tumors—with the exception of prolactinomas.  However, most aggressive pituitary tumors require repeat surgery.

If surgery is unlikely to improve symptoms, then pharmacotherapies are useful.  They may also be used as an adjunct therapy to surgery. Types of medications that work well for aggressive pituitary tumors include:

  • dopamine agonists for prolactinomas (first-line treatment)
  • somatostatin analogs are effective for primary therapy, either before surgery or after surgery, to control tumor re-growth of pituitary adenomas

Radiotherapy can be used when surgery and pharmacotherapies fail.  While conventional chemotherapy is not effective, there have been recent case reports with temoxolomide (an alkylating agent) that have shown better results in the short-term.

Opinion of Article Authors
It’s the opinion of the article authors that to improve the overall response rate to aggressive pituitary tumor treatment, there must be early application of current therapeutic approaches as well as incorporation of new therapeutic developments.

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