Therapeutic response for medical therapy in hormonally functioning pituitary tumours is different in various types of tumours. While majority of prolactinomas respond well for medical therapy using dopamine agonists, in other tumours like somatotropinoma or corticotropinoma their response is significantly lower. In some case therapy resistance can occur. There are various factors determining the efficacy of medical therapy in patients harboring functioning pituitary adenomas. They are different for certain type of tumour. Among clinical aspects, gender, age and extent of hormonal hypersecretion are important factors. In general, response for the therapy in acromegaly is poor in younger male patients with larger tumours and greater GH hypersecretion. Pituitary imaging using MRI can show tumour size and invasiveness, together with T2 intensity. Histological and molecular analyses assess granulation pattern, somatostatin and dopamine receptors number and expression, Ki-67 index, mitotic activity, p53 immunoreactivity, AIP expression, genetic mutations and polymorphisms. The knowledge of possible factors influencing therapeutic response is important and may be helpful in the choice of optimal individualized therapy.
20 - 23 May 2017
European Society of Endocrinology