$Anti-VEGF Therapy in Refractory Pituitary Adenomas and Pituitary Carcinomas: A Review$
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Anti-VEGF Therapy in Refractory Pituitary Adenomas and Pituitary Carcinomas: A Review

Most pituitary tumors are considered benign adenomas, and only 0.1%–0.2% of them present metastasis and are defined as pituitary carcinomas (PCs). Refractory pituitary adenomas (PAs) lie between benign adenomas and true malignant PCs and are defined as aggressive-invasive PAs, characterized by a hig...

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Autores principales:	Congxin Dai, Siyu Liang, Bowen Sun, Yong Li, Jun Kang
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	refractory pituitary adenomas pituitary carcinomas VEGF anti-VEGF vascular endothelial growth inhibitor Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
Acceso en línea:	https://doaj.org/article/8fe4900f61c6430098f966006066a7df
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spelling	oai:doaj.org-article:8fe4900f61c6430098f966006066a7df2021-11-17T05:14:00ZAnti-VEGF Therapy in Refractory Pituitary Adenomas and Pituitary Carcinomas: A Review2234-943X10.3389/fonc.2021.773905https://doaj.org/article/8fe4900f61c6430098f966006066a7df2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fonc.2021.773905/fullhttps://doaj.org/toc/2234-943XMost pituitary tumors are considered benign adenomas, and only 0.1%–0.2% of them present metastasis and are defined as pituitary carcinomas (PCs). Refractory pituitary adenomas (PAs) lie between benign adenomas and true malignant PCs and are defined as aggressive-invasive PAs, characterized by a high Ki-67 index, rapid growth, frequent recurrence, and resistance to conventional treatments. Refractory PAs and PCs are notoriously difficult to manage because of limited therapeutic options. Vascular endothelial growth factor (VEGF) plays a crucial role in angiogenesis not only during development but also during pathological processes in pituitary tumors. Recently, increasing numbers of preclinical studies and clinical research have demonstrated that anti-VEGF therapy plays an important role in pituitary tumors. The purpose of this review is to report the role of VEGF in the development and pathology of pituitary tumors and the progress of anti-VEGF therapy in pituitary tumors, including refractory PAs and PCs. Previous preclinical studies indicated that cyclin-dependent kinase 5 (CDK5)-mediated VEGF expression might play a crucial role in the development of PAs. Vascular endothelial growth inhibitors have been reported as independent predictors of invasion in human PAs and have been indicated as markers for poor outcome. Furthermore, several studies have reported that angiogenesis decreases tumor sizes in experimental animal models of pituitary tumors. The expression of VEGF is relatively high in PAs; therefore, anti-VEGF therapy has been used in some refractory PAs and PCs. To date, anti-VEGF has been reported as monotherapy, in combination with temozolomide (TMZ), TMZ and radiotherapy, and with pasireotide, which might be a promising alternative therapy for refractory PAs and PCs resistant to conventional treatments. However, the role of anti-VEGF therapy in pituitary tumors is still controversial due to a lack of large-scale clinical trials. In summary, the results from preclinical studies and clinical trials indicated that anti-VEGF therapy monotherapy or in combination with other treatments may be a promising alternative therapy for refractory PAs and PCs resistant to conventional treatments. More preclinical studies and clinical trials are needed to further evaluate the exact efficacy of anti-VEGF in refractory PAs and PCs.Congxin DaiSiyu LiangBowen SunYong LiJun KangFrontiers Media S.A.articlerefractory pituitary adenomaspituitary carcinomasVEGFanti-VEGFvascular endothelial growth inhibitorNeoplasms. Tumors. Oncology. Including cancer and carcinogensRC254-282ENFrontiers in Oncology, Vol 11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	refractory pituitary adenomas pituitary carcinomas VEGF anti-VEGF vascular endothelial growth inhibitor Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282
spellingShingle	refractory pituitary adenomas pituitary carcinomas VEGF anti-VEGF vascular endothelial growth inhibitor Neoplasms. Tumors. Oncology. Including cancer and carcinogens RC254-282 Congxin Dai Siyu Liang Bowen Sun Yong Li Jun Kang Anti-VEGF Therapy in Refractory Pituitary Adenomas and Pituitary Carcinomas: A Review
description	Most pituitary tumors are considered benign adenomas, and only 0.1%–0.2% of them present metastasis and are defined as pituitary carcinomas (PCs). Refractory pituitary adenomas (PAs) lie between benign adenomas and true malignant PCs and are defined as aggressive-invasive PAs, characterized by a high Ki-67 index, rapid growth, frequent recurrence, and resistance to conventional treatments. Refractory PAs and PCs are notoriously difficult to manage because of limited therapeutic options. Vascular endothelial growth factor (VEGF) plays a crucial role in angiogenesis not only during development but also during pathological processes in pituitary tumors. Recently, increasing numbers of preclinical studies and clinical research have demonstrated that anti-VEGF therapy plays an important role in pituitary tumors. The purpose of this review is to report the role of VEGF in the development and pathology of pituitary tumors and the progress of anti-VEGF therapy in pituitary tumors, including refractory PAs and PCs. Previous preclinical studies indicated that cyclin-dependent kinase 5 (CDK5)-mediated VEGF expression might play a crucial role in the development of PAs. Vascular endothelial growth inhibitors have been reported as independent predictors of invasion in human PAs and have been indicated as markers for poor outcome. Furthermore, several studies have reported that angiogenesis decreases tumor sizes in experimental animal models of pituitary tumors. The expression of VEGF is relatively high in PAs; therefore, anti-VEGF therapy has been used in some refractory PAs and PCs. To date, anti-VEGF has been reported as monotherapy, in combination with temozolomide (TMZ), TMZ and radiotherapy, and with pasireotide, which might be a promising alternative therapy for refractory PAs and PCs resistant to conventional treatments. However, the role of anti-VEGF therapy in pituitary tumors is still controversial due to a lack of large-scale clinical trials. In summary, the results from preclinical studies and clinical trials indicated that anti-VEGF therapy monotherapy or in combination with other treatments may be a promising alternative therapy for refractory PAs and PCs resistant to conventional treatments. More preclinical studies and clinical trials are needed to further evaluate the exact efficacy of anti-VEGF in refractory PAs and PCs.
format	article
author	Congxin Dai Siyu Liang Bowen Sun Yong Li Jun Kang
author_facet	Congxin Dai Siyu Liang Bowen Sun Yong Li Jun Kang
author_sort	Congxin Dai
title	Anti-VEGF Therapy in Refractory Pituitary Adenomas and Pituitary Carcinomas: A Review
title_short	Anti-VEGF Therapy in Refractory Pituitary Adenomas and Pituitary Carcinomas: A Review
title_full	Anti-VEGF Therapy in Refractory Pituitary Adenomas and Pituitary Carcinomas: A Review
title_fullStr	Anti-VEGF Therapy in Refractory Pituitary Adenomas and Pituitary Carcinomas: A Review
title_full_unstemmed	Anti-VEGF Therapy in Refractory Pituitary Adenomas and Pituitary Carcinomas: A Review
title_sort	anti-vegf therapy in refractory pituitary adenomas and pituitary carcinomas: a review
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/8fe4900f61c6430098f966006066a7df
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Anti-VEGF Therapy in Refractory Pituitary Adenomas and Pituitary Carcinomas: A Review

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