<i>In Vivo</i>Detection of Somatostatin Receptors in Patients with Functionless Pituitary Adenomas by Means of a Radioiodinated Analog of Somatostatin ([<sup>123</sup>I]SDZ 204–090)*

Faglia, G.; Bazzoni, Nicoletta; Spada, Anna; Arosio, Maura; Ambrosi, Bruno; Spinelli, F.; Sara, Roberto; Bonino, C.; Lunghi, Fabio

doi:10.1210/jcem-73-4-850

Cited by 61 publications

(29 citation statements)

References 26 publications

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“…The introduction of dopamine agonists in the medical therapy of NFAs was based on the observation that dopamine receptors are present in vitro in NFA cells, as in prolactinoma cells [101, 102, 103]. Bromocriptine, the first dopamine agonist available for therapeutic purposes, was used in NFAs with disappointing results, probably due to the lower amount and affinity of D 2 receptors expressed on NFAs than on prolactinoma cells [89].…”

Section: Clinically Non-functioning Pituitary Adenomasmentioning

confidence: 99%

New Medical Approaches in Pituitary Adenomas

et al. 2000

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Recently, the medical approach to patients with secreting and clinically non-functioning pituitary adenomas has received great impulse thanks to the availability of new, selective and long-lasting compounds with dopaminergic activity, such as cabergoline, and of somatostatin analogues provided in slow-release formulations, such as lanreotide and octreotide long acting release (LAR). In particular, the use of cabergoline has induced control of hyperprolactinaemia and tumour shrinkage in the great majority of patients with micro- and macroprolactinomas. Cabergoline treatment restores fertility both in women and men, and partially improves osteoporosis, one of the major complications of hyperprolactinaemia. In acromegaly, disease control (growth hormone [GH] <2.5–1.0 μg/l as a fasting or glucose-suppressed value, respectively, together with age-normalised insulin-like growth factor [IGF]-I) is achievable in more than half of patients receiving treatment with lanreotide or octreotide-LAR. Improvement in cardiomyopathy, sleep apnoea and arthropathy has been reported during GH/IGF-I suppression after pharmacotherapy. A synthetic GH analogue, B2036-PEG, that antagonises endogenous GH binding to its receptor-binding sites and a GH-releasing hormone antagonist that blocks the effect of this releasing factor on the hypothalamus and pituitary are presently under investigation in acromegaly. Preliminary studies have clearly demonstrated the effectiveness of the GH receptor antagonist in suppressing IGF-I levels in acromegalic patients previously unresponsive to somatostatin analogues. Beneficial effects of subcutaneous octreotide and lanreotide have also been reported in adenomas secreting thyroid-stimulating hormone, while the results of treatment with dopamine agonists or somatostatin analogues remain disappointing in patients with clinically non-functioning adenomas. In these patients the possibility of visualising in vivo the expression of D₂ receptors using specific radiotracers such as ¹²³I-methoxybenzamide has allowed selection of patients likely to respond to cabergoline. Scant effects of pharmacotherapy have also been reported in patients with adenomas secreting adrenocorticotropic hormone. However, some preliminary data suggest a potential use of cabergoline in combination with ketoconazole, or alone, in selected cases of Cushing’s disease or Nelson’s syndrome.

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Section: Clinically Non-functioning Pituitary Adenomasmentioning

confidence: 99%

New Medical Approaches in Pituitary Adenomas

et al. 2000

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“…There is a rationale for both dopamine agonists and somatostatin analogues in the treatment of NFA in accordance with in vitro and in vivo evidence of dopamine and somatostatin receptor expression in this adenoma histotype (7,(35)(36)(37)(38)(39)(40)(41)(42). However, the results of bromocriptine, quinagolide (36)(37)(38)(39)(40) and octreotide treatment (43)(44)(45)(46) were disappointing in almost all studies, except for some case reports.…”

Section: Non-functioning Pituitary Adenomasmentioning

confidence: 97%

Combined therapy of somatostatin analogues and dopamine agonists in the treatment of pituitary tumours

Colao

Filippella²,

Pivonello

et al. 2007

eur j endocrinol

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Pituitary tumours express both somatostatin and dopamine receptors. Medical treatment with somatostatin analogues is a cornerstone of GH-and TSH-secreting tumours, while treatment with dopamine agonists is a cornerstone of prolactin-secreting tumours. Dopamine agonists have also demonstrated some efficacy in patients with GH-and TSH-secreting adenomas. Neither ACTHsecreting nor clinically non-functioning tumours have a well-established medical treatment. Nevertheless, some recent results have indicated a potential usefulness of the dopamine agonist cabergoline in patients with pituitary-dependent Cushing's disease. Combination treatment with both somatostatin analogues and dopamine agonists has been poorly investigated. Some studies conducted in small series have documented an additive effect of both drugs in patients with GH-secreting adenomas. Of mention is that none of the studies were randomised and cross-sectional so that the results should be confirmed by other well-designed studies. No data are available in other pituitary tumour histotypes. Preliminary observations in patients with clinically non-functioning adenomas are very promising.

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“…Receptores somatostatínicos (SSTR) foram detectados através do octreoscan em 25 a 75% dos ACNF (91,128,129). No entanto, os efeitos benéficos da terapia com octreotida foram variáveis e infreqüentes (98,102), correlacionandose pobremente com a presença dos SSTR (81,130).…”

Section: Análogos Somatostatínicosunclassified

Tratamento medicamentoso dos tumores hipofisários. parte II: adenomas secretores de ACTH, TSH e adenomas clinicamente não-funcionantes

Vilar

Naves

Freitas

et al. 2000

Arq Bras Endocrinol Metab

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This article reviews the potencial role of medical treatment for both ACTH and TSH secreting pituitary adenomas, as well as for clinically non-functionning pituitary adenomas (CNFPA). Metyrapone, mitotane and ketoconazole (preferable for causing less side-effects) are the most effective drugs for the control of hypercortisolism but none of them surpasses the efficacy of transsphenoidal surgery (TSA). Drug therapy in Cushing's disease is therefore better indicated for patients waiting for the full effect of radiotherapy or, as an alternative to radiotherapy, for cases of TSA failure as well as patients that refuse or have clinical limitations to surgery. Other potential indications for medical treatment in Cushing's disease include elderly patients with microadenomas or small macroadenomas, as well as cases associated to an empty sella. Concerning TSH-secreting adenomas, somatostatin analogues (SRIFa) lead to normalization of thyroid hormones in up to 95% of treated patients. Therefore they may represent an useful tool for long-term treatment of such rare tumors in case of surgery failure or as primary therapy for selected cases. Occasionaly, dopamine agonists (DA), especially cabergoline, may also be efficacious in normalizing hormone levels. In contrast, DA and SRIFa rarely induce significant tumor shrinkage in patients with CNFPA. Thus, these drugs should be considered particularly for patients who are poor candidates for surgery or in whom surgery and radiotherapy have failed to control the disease. (Arq Bras Endocrinol Metab 2000;44/6: 455-470)

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In VivoDetection of Somatostatin Receptors in Patients with Functionless Pituitary Adenomas by Means of a Radioiodinated Analog of Somatostatin ([¹²³I]SDZ 204–090)*

Cited by 61 publications

References 26 publications

New Medical Approaches in Pituitary Adenomas

New Medical Approaches in Pituitary Adenomas

Combined therapy of somatostatin analogues and dopamine agonists in the treatment of pituitary tumours

Tratamento medicamentoso dos tumores hipofisários. parte II: adenomas secretores de ACTH, TSH e adenomas clinicamente não-funcionantes

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In VivoDetection of Somatostatin Receptors in Patients with Functionless Pituitary Adenomas by Means of a Radioiodinated Analog of Somatostatin ([123I]SDZ 204–090)*

Cited by 61 publications

References 26 publications

New Medical Approaches in Pituitary Adenomas

New Medical Approaches in Pituitary Adenomas

Combined therapy of somatostatin analogues and dopamine agonists in the treatment of pituitary tumours

Tratamento medicamentoso dos tumores hipofisários. parte II: adenomas secretores de ACTH, TSH e adenomas clinicamente não-funcionantes

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In VivoDetection of Somatostatin Receptors in Patients with Functionless Pituitary Adenomas by Means of a Radioiodinated Analog of Somatostatin ([¹²³I]SDZ 204–090)*