Please use this identifier to cite or link to this item: https://hdl.handle.net/2445/222962
Title: Predictors of therapeutic failure in GH and prolactin co-secreting pituitary adenomas
Author: Araujo Castro, Marta
Biagetti, Betina
Menéndez, Edelmiro
Novoa Testa, Iria
Cordido, Fernando
Rodríguez Berrocal, Víctor
Pascual Corrales, Eider
Guerrero Pérez, Fernando
Vicente, Almudena
García Centeno, Rogelio
González Fernández, Laura
Ollero García, María Dolores
Irigaray Echarri, Ana
Moure Rodríguez, María Dolores
Novo Rodríguez, Cristina
Calatayud, María
Villar Taibo, Rocío
Bernabéu, Ignacio
Álvarez Escolá, Cristina
Tenorio Jimenéz, Carmen
Abellán Galiana, Pablo
Venegas Moreno, Eva
González Molero, Inmaculada
Iglesias, Pedro
Blanco, Concepción
Vidal Ostos de Lara, Fernando
Miguel Novoa, María de la Paz de
López Mezquita Torres, Elena
Hanzu, Felicia A.
Lamas, Cristina
Aznar Rodríguez, Silvia
Aulinas, Anna
Recio Córdova, Jose M.
Aviles Pérez, María Dolores
Sampedro Nuñez, Miguel Antonio
Cámara, Rosa
Paja Fano, Miguel
Fajardo Montañana, Carmen
Cardoso, Luís
Marques, Pedro
Martínez Sáez, Elena
Ruz Caracuel, Ignacio
Marazuela, Mónica
Puig Domingo, Manuel
Keywords: Malalties de la hipòfisi
Cirurgia endocrina
Terapèutica
Pituitary gland diseases
Endocrine surgery
Therapeutics
Issue Date: 1-Jul-2025
Publisher: Bioscientifica
Abstract: Aim: To evaluate which factors are associated with a higher probability of failure to surgical and first-generation somatostatin receptor ligands (fgSRLs) treatment in patients with growth hormone and prolactin co-secreting pituitary adenomas (GH&PRL-PAs). Methods: Acromegaly patients with GH&PRL-PAs included in the ACRO-SPAIN study were enrolled. GH&PRL-PAs were defined as tumors with serum PRL levels above the upper limit of normal and positive immunostaining for GH and PRL, or with PRL levels >= 100 ng/mL when immunostaining data were not available. Results: A total of 126 acromegaly patients with GH&PRL-PAs who underwent transsphenoidal pituitary surgery were included, and 42.1% (n = 53) were biochemically cured at the immediate postoperative evaluation. Knosp grade >2 (odds ratio (OR) 3.48, 95% CI 1.28-9.38), higher serum GH (OR 1.01, 95% CI 1.01-1.08) and IGF-1 (OR 1.60, 95% CI 1.05-2.45) levels were associated with a lower probability of surgical cure. Sixty-eight patients received first-line medical therapy as follows: fgSRLs in monotherapy (n = 22), fgSRL plus cabergoline (n = 37), cabergoline in monotherapy (n = 7) and pegvisomant in monotherapy (n = 2). Among the cases treated with fgSRL in monotherapy, 18.2% (n = 4/22) were resistant. We identified as predictors of fgSRL resistance (in monotherapy and combined with cabergoline) a Knosp grade >2 (OR 8.75, P = 0.003), high GH levels at acromegaly diagnosis (OR 1.02, P = 0.031) and higher postoperative GH levels (OR 1.05, P = 0.006), but no predictors of response to fgSRL in monotherapy were identified. Conclusion: The clinical predictors of surgical failure and of fgSRL resistance in patients with GH&PRL-PAs are similar to those described in acromegaly without PRL, co-secretion.
Note: Reproducció del document publicat a: https://doi.org/10.1530/EC-25-0103
It is part of: Endocrine Connections, 2025, vol. 14, num. 7
URI: https://hdl.handle.net/2445/222962
Related resource: https://doi.org/10.1530/EC-25-0103
ISSN: 2049-3614
Appears in Collections:Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

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