Cabergoline in the Management of Residual Nonfunctioning Pituitary Adenoma A Single-Center, Open-Label, 2-Year Randomized Clinical Trial

被引:43
作者
Batista, Rafael L. [1 ]
Musolino, Nina R. C. [1 ]
Cescato, Valter A. S. [1 ]
da Silva, Gilberto O. [1 ]
Medeiros, Raphael S. S. [2 ]
Herkenhoff, Clarissa G. B. [1 ]
Trarbach, Ericka B. [3 ]
Cunha-Neto, Malebranche B. [1 ]
机构
[1] FMUSP, Hosp Clin, Inst Psychiat IPq, Div Funct Neurosurg, Sao Paulo, SP, Brazil
[2] FMUSP, Hosp Clin, Div Pathol Anat, Sao Paulo, Brazil
[3] FMUSP, Hosp Clin, Discipline Endocrinol, Lab Cellular & Mol Endocrinol,LIM25, Sao Paulo, SP, Brazil
来源
AMERICAN JOURNAL OF CLINICAL ONCOLOGY-CANCER CLINICAL TRIALS | 2019年 / 42卷 / 02期
基金
巴西圣保罗研究基金会;
关键词
nonfunctioning adenoma; cabergoline; D2R expression; RECEPTOR EXPRESSION; MEDICAL THERAPY; DOPAMINE; RADIOTHERAPY; DIAGNOSIS; MORTALITY; DISEASE;
D O I
10.1097/COC.0000000000000505
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: Complete tumor removal by transsphenoidal surgery is usually difficult for large nonfunctioning pituitary adenomas (NFPAs). A validated medical treatment may be useful for their management. This study evaluates the clinical efficacy of the dopaminergic agonist cabergoline for residual NFPA. Design, Setting, and Participants: We conducted a randomized, parallel, open-label clinical trial that compared cabergoline with nonintervention in patients with residual NFPA after transsphenoidal surgery over 2 years. The primary outcome was clinical efficacy (tumor reduction). The secondary outcome was the relationship between tumor dopamine D2 receptor (D2R) expression and clinical responsiveness. Tumor measurements and clinical evaluations were performed every 6 months. Results: In total, 59 and 57 individuals were randomly assigned to the study and control groups, respectively. At the end of the study, residual tumor shrinkage, stabilization, and enlargement were observed in 28.8%, 66.1%, and 5.1% of patients, respectively, in the medical-therapy group and in 10.5%, 73.7%, and 15.8% of patients, respectively, in the control group (P=0.01). The progression-free survival rate was 23.2 and 20.8 months for the study and control groups, respectively (P=0.01). D2R was not associated with cabergoline responsiveness. No major side effects were related to cabergoline use. Conclusions: Cabergoline was an effective drug for treating residual NFPA, and its use was associated with a high rate of tumor shrinkage ( NCT03271918).
引用
收藏
页码:221 / 227
页数:7
相关论文
共 34 条
  • [1] Mortality following pituitary radiotherapy
    Ayuk, John
    Stewart, Paul M.
    [J]. PITUITARY, 2009, 12 (01) : 35 - 39
  • [2] Progression of an Invasive ACTH Pituitary Macroadenoma with Cushing's Disease to Pituitary Carcinoma
    Borba, Clarissa Groberio
    Batista, Rafael Loch
    de Castro Musolino, Nina Rosa
    Machado, Vanielle Carvalho
    Evangelista Alcantara, Ana Elisa
    da Silva, Gilberto Ochman
    Sperling Cescato, Valter Angelo
    Carneiro da Cunha Neto, Andmalebranche Berardo
    [J]. CASE REPORTS IN ONCOLOGICAL MEDICINE, 2015, 2015
  • [3] Cabergoline-related impulse control disorder in an adolescent with a giant prolactinoma
    Bulwer, C.
    Conn, R.
    Shankar, A.
    Ferrau, F.
    Kapur, S.
    Ederies, A.
    Korbonits, M.
    Spoudeas, H. A.
    [J]. CLINICAL ENDOCRINOLOGY, 2017, 86 (06) : 862 - 864
  • [4] Non-functioning pituitary adenoma: When and how to operate? What pathologic criteria for typing?
    Castinetti, Frederic
    Dufour, Henry
    Gaillard, Stephane
    Jouanneau, Emmanuel
    Vasiljevic, Alexandre
    Villa, Chiara
    Trouillas, Jacqueline
    [J]. ANNALES D ENDOCRINOLOGIE, 2015, 76 (03) : 220 - 227
  • [5] Management of clinically non-functioning pituitary adenoma
    Chanson, Philippe
    Raverot, Gerald
    Castinetti, Frederic
    Cortet-Rudelli, Christine
    Galland, Francoise
    Salenave, Sylvie
    [J]. ANNALES D ENDOCRINOLOGIE, 2015, 76 (03) : 239 - 247
  • [6] Medical therapy for clinically non-functioning pituitary adenomas
    Colao, Annamaria
    Di Somma, Carolina
    Pivonello, Rosario
    Faggiano, Antongiulio
    Lombardi, Gaetano
    Savastano, Silvia
    [J]. ENDOCRINE-RELATED CANCER, 2008, 15 (04) : 905 - 915
  • [7] Psychostimulant Effect of Dopaminergic Treatment and Addictions in Parkinson's Disease
    Delpont, Benoit
    Lhommee, Eugenie
    Klinger, Helene
    Schmitt, Emmanuelle
    Bichon, Amelie
    Fraix, Valerie
    Castrioto, Anna
    Quesada, Jean-Louis
    Pelissier, Pierre
    Kistner, Andrea
    Carnicella, Sebastien
    Luescher, Christian
    Broussolle, Emmanuel
    Pollak, Pierre
    Thobois, Stephane
    Krack, Paul
    [J]. MOVEMENT DISORDERS, 2017, 32 (11) : 1566 - 1573
  • [8] DICHIRO G, 1962, AMER J ROENTGENOL RA, V87, P989
  • [9] Dopamine 2 and Somatostatin 1-5 Receptors Coexpression in Clinically Non-Functioning Pituitary Adenomas
    Gabalec, F.
    Drastikova, M.
    Cesak, T.
    Netuka, D.
    Masopust, V.
    Machac, J.
    Marek, J.
    Cap, J.
    Beranek, M.
    [J]. PHYSIOLOGICAL RESEARCH, 2015, 64 (03) : 369 - 377
  • [10] Dopamine 2 receptor expression in various pathological types of clinically non-functioning pituitary adenomas
    Gabalec, Filip
    Beranek, Martin
    Netuka, David
    Masopust, Vaclav
    Nahlovsky, Jiri
    Cesak, Tomas
    Marek, Josef
    Cap, Jan
    [J]. PITUITARY, 2012, 15 (02) : 222 - 226