Treatment of Aggressive Pituitary Adenomas: A Case-Based Narrative Review

Management of aggressive pituitary adenomas is challenging due to a paucity of rigorous evidence supporting available treatment approaches. Recent guidelines emphasize the need to maximize standard therapies as well as the use of temozolomide and radiation therapy to treat disease recurrence. Howeve...

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Autores principales:	Odelia Cooper, Vivien Bonert, Ning-Ai Liu, Adam N. Mamelak
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	pituitary adenomas surgery radiation therapy temozolomide targeted therapy aggressive adenomas Diseases of the endocrine glands. Clinical endocrinology RC648-665
Acceso en línea:	https://doaj.org/article/f20a4e602f0d4dc3aeab27b1c89800d9
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spelling	oai:doaj.org-article:f20a4e602f0d4dc3aeab27b1c89800d92021-11-15T06:33:36ZTreatment of Aggressive Pituitary Adenomas: A Case-Based Narrative Review1664-239210.3389/fendo.2021.725014https://doaj.org/article/f20a4e602f0d4dc3aeab27b1c89800d92021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fendo.2021.725014/fullhttps://doaj.org/toc/1664-2392Management of aggressive pituitary adenomas is challenging due to a paucity of rigorous evidence supporting available treatment approaches. Recent guidelines emphasize the need to maximize standard therapies as well as the use of temozolomide and radiation therapy to treat disease recurrence. However, often these adenomas continue to progress over time, necessitating the use of additional targeted therapies which also impact quality of life and long-term outcomes. In this review, we present 9 cases of aggressive pituitary adenomas to illustrate the importance of a multidisciplinary, individualized approach. The timing and rationale for surgery, radiation therapy, temozolomide, somatostatin receptor ligands, and EGFR, VEGF, and mTOR inhibitors in each case are discussed within the context of evidence-based guidelines and clarify strategies for implementing an individualized approach in the management of these difficult-to-treat-adenomas.Odelia CooperVivien BonertNing-Ai LiuAdam N. MamelakAdam N. MamelakFrontiers Media S.A.articlepituitary adenomassurgeryradiation therapytemozolomidetargeted therapyaggressive adenomasDiseases of the endocrine glands. Clinical endocrinologyRC648-665ENFrontiers in Endocrinology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	pituitary adenomas surgery radiation therapy temozolomide targeted therapy aggressive adenomas Diseases of the endocrine glands. Clinical endocrinology RC648-665
spellingShingle	pituitary adenomas surgery radiation therapy temozolomide targeted therapy aggressive adenomas Diseases of the endocrine glands. Clinical endocrinology RC648-665 Odelia Cooper Vivien Bonert Ning-Ai Liu Adam N. Mamelak Adam N. Mamelak Treatment of Aggressive Pituitary Adenomas: A Case-Based Narrative Review
description	Management of aggressive pituitary adenomas is challenging due to a paucity of rigorous evidence supporting available treatment approaches. Recent guidelines emphasize the need to maximize standard therapies as well as the use of temozolomide and radiation therapy to treat disease recurrence. However, often these adenomas continue to progress over time, necessitating the use of additional targeted therapies which also impact quality of life and long-term outcomes. In this review, we present 9 cases of aggressive pituitary adenomas to illustrate the importance of a multidisciplinary, individualized approach. The timing and rationale for surgery, radiation therapy, temozolomide, somatostatin receptor ligands, and EGFR, VEGF, and mTOR inhibitors in each case are discussed within the context of evidence-based guidelines and clarify strategies for implementing an individualized approach in the management of these difficult-to-treat-adenomas.
format	article
author	Odelia Cooper Vivien Bonert Ning-Ai Liu Adam N. Mamelak Adam N. Mamelak
author_facet	Odelia Cooper Vivien Bonert Ning-Ai Liu Adam N. Mamelak Adam N. Mamelak
author_sort	Odelia Cooper
title	Treatment of Aggressive Pituitary Adenomas: A Case-Based Narrative Review
title_short	Treatment of Aggressive Pituitary Adenomas: A Case-Based Narrative Review
title_full	Treatment of Aggressive Pituitary Adenomas: A Case-Based Narrative Review
title_fullStr	Treatment of Aggressive Pituitary Adenomas: A Case-Based Narrative Review
title_full_unstemmed	Treatment of Aggressive Pituitary Adenomas: A Case-Based Narrative Review
title_sort	treatment of aggressive pituitary adenomas: a case-based narrative review
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/f20a4e602f0d4dc3aeab27b1c89800d9
work_keys_str_mv	AT odeliacooper treatmentofaggressivepituitaryadenomasacasebasednarrativereview AT vivienbonert treatmentofaggressivepituitaryadenomasacasebasednarrativereview AT ningailiu treatmentofaggressivepituitaryadenomasacasebasednarrativereview AT adamnmamelak treatmentofaggressivepituitaryadenomasacasebasednarrativereview AT adamnmamelak treatmentofaggressivepituitaryadenomasacasebasednarrativereview
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Treatment of Aggressive Pituitary Adenomas: A Case-Based Narrative Review

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