SFEBES2023 Poster Presentations Neuroendocrinology and Pituitary (74 abstracts)
Effectiveness of Dopamine Agonists in managing Non-Functioning Pituitary Adenomas- a United Kingdom single centre retrospective review
Trevor Tam 1 , Elaine Soong 2 , Louis Saada 2 , Hani Marcus 3,4 , Neil Dorward 3,4 , Francesca Swords 2 , Ketan Dhatariya 1,2 & Rupa Ahluwalia 2
1University of East Anglia, Norwich, United Kingdom. 2Norfolk and Norwich University Hospital, Norwich, United Kingdom. 3National Hospital for Neurology and Neurosurgery, London, United Kingdom. 4University College London, London, United Kingdom
Background: While dopamine agonists (DAs) are used for managing residual/recurrent non-functioning pituitary adenomas (NFPAs), guidance on patient selection, drug dosing, follow-up imaging and response criteria is lacking.
Methods: Retrospective review of NFPAs treated with DAs at a U.K single centre. 14 patients on Cabergoline (November 2011-2022) were identified. Radiological response was based on 2 follow-up (FU) scans or imaging at 12 months. Tumour shrinkage defined as > 20% reduction in volume; tumour stabilisation was defined as 0-20% reduction in volume; tumour growth was defined as any increase in volume. 3 patients were excluded (2-prolactinomas, 1-insufficient data).
Results: In a total 11 patients (mean age 67.73 years; median age 65.5 ± 23.5 years) (45.5% females). Cabergoline was commenced pre surgery, due to inoperability or post-surgery and radiotherapy. At time of submission, 8 had repeat scans (1 awaiting 1st scan, 1 excluded as DA stopped due to intolerance, 1 couldn’t tolerate MRI). Variable time to 1st FU scan (3 – 13 months) with 50% of 1st FU scans in 6 months.50% of patients demonstrated either tumour shrinkage (25%) or stabilisation (25%), while tumour growth despite DA therapy was observed in 50% of patients.
| Patient number | Time to 1st FU scan (months) | Cabergoline dosage (mg) and frequency | Results |
| 1 | 12 | 250, OW | Shrinkage |
| 2 | 8 | 500, twice weekly | Shrinkage |
| 4 | 11 | 500, 3x a week | Stable |
| 6 | 11 | 500, OW | Increase |
| 7 | 6 | 250, OW | Increase |
| 8 | 6 | 250, twice weekly | Stable |
| 10 | 4 | 250, twice weekly | Increase |
| 11 | 3 | 250, OD | Increase |
Conclusion: We report a limited role of DA therapy in preventing tumour growth within a small cohort. Further multicentre studies are warranted for guiding more selective use of DA in management of NFPA.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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