[en] Prolactinomas are the most commonly encountered pituitary adenomas in the clinical setting. While most can be controlled by dopamine agonists, a subset of prolactinomas are dopamine-resistant and very aggressive. In such tumors, the treatment of choice is neurosurgery and radiotherapy, with or without temozolomide. Here, we report a patient with an highly aggressive, dopamine-resistant prolactinoma, who only achieved biochemical and tumor control during pasireotide long-acting release (PAS-LAR) therapy , a second-generation somatostatin receptor ligand (SRL). Interestingly, cystic degeneration, tumor cell necrosis, or both was observed after PAS-LAR administration suggesting an antitumor effect. This case shows that PAS-LAR therapy holds clinical potential in selective aggressive, dopamine-resistant prolactinomas that express somatostatin (SST) receptor subtype 5 and appears to be a potential new treatment option before starting temozolomide. In addition, PAS-LAR therapy may induce cystic degeneration, tumor cell necrosis, or both in prolactinomas.
Disciplines :
Endocrinology, metabolism & nutrition
Author, co-author :
Coopmans, Eva C.
van Meyel, Sebastiaan W. F.
Pieterman, Kay J.
van Ipenburg, Jolique A.
Hofland, Leo
Donga, Esther
Daly, Adrian ; Université de Liège - ULiège > Département des sciences cliniques > Endocrinologie
Beckers, Albert ; Université de Liège - ULiège > Département des sciences cliniques > Endocrinologie
Van der Lely, A. J.
Neggers, Sebastian J. C. M. M.
Language :
English
Title :
Excellent response to pasireotide therapy in an aggressive and dopamine-resistant prolactinoma.
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