Medical Treatment of Pituitary Adenomas: A Celebration of Endocrinology (and Oncology)!

Not many people today realize that pituitary tumors were among the first neoplasms to be treated medically in all of oncology: the observation that an ergot alkaloid (2-Br-ergocryptine, bromocriptine) may treat prolactin-producing tumors, first made in rodents, dates from the mid-1970’s [1]. At the time, very few neoplasms could be treated medically; it was only a decade after the discovery of the first chemotherapy for any cancer: the use of methotrexate for choriocarcinoma [2].

There is therefore no better way to celebrate our anniversary than featuring in this issue a review by Maria Fleseriu and her colleagues on the medical treatment of pituitary adenomas [3]. This extensive article covers all recent updates on the use of a variety of pharmacological approaches to the treatment of pituitary adenomas and/or their hormonal consequences from the use of dopaminergic agonists and somatostatin receptor ligands to steroidogenesis inhibitors and glucocorticoid receptor antagonists in Cushing syndrome due to corticotropin-producing adenomas.

The article follows a number of recent articles in our journal on the treatment and genetics of pituitary tumors; some are listed here as examples [4] [5] [6] [7].

What an amazing progress in the field! “Quam celerrime ad astra” (“speedily to the stars”) is what comes to mind when one talks about medical treatment of pituitary tumors: we are not far from the day that molecularly targeted therapies will be used for one of the most common neoplasms of endocrine oncology…

• References

• 1 Spark RF, Dickstein G.. Bromocriptine and endocrine disorders. Ann Intern Med 1979; 90: 949-956
• 2 Hertz R, Ross GT, Lipsett MB.. Primary chemotherapy of nonmetastatic trophoblastic disease in women. Am J Obstet Gynecol 1963; 86: 808-814
• 3 Gheorghiu ML, Negreanu F, Fleseriu M.. Updates in the medical treatment of pituitary adenomas. Horm Metab Res. 2020; 52: 8-24
• 4 Xekouki P, Brennand A, Whitelaw B. et al. The 3PAs: An update on the association of pheochromocytomas, paragangliomas, and pituitary tumors. Horm Metab Res 2019; 51: 419-436
• 5 Petersenn S.. Management of aggressive pituitary tumors – a 2019 update. Horm Metab Res 2019; 51: 755-764
• 6 Polidoro MA, Rotondi S, Morace R. et al. Expression of peroxisome proliferator-activated receptor alpha (PPARα) in non-somatotroph pituitary tumours and the effects of PPARα agonists on MMQ cells. Horm Metab Res 2018; 50: 640-647
• 7 Feng Y, Mao ZG, Wang X. et al. MicroRNAs and target genes in pituitary adenomas. Horm Metab Res 2018; 50: 179-192