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2025-07-01

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cc-by (c) Araujo Castro, Marta et al., 2025
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/222962

Predictors of therapeutic failure in GH and prolactin co-secreting pituitary adenomas

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https://doi.org/10.1530/EC-25-0103

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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.

Matèries

Malalties de la hipòfisi, Cirurgia endocrina, Terapèutica

Matèries (anglès)

Pituitary gland diseases, Endocrine surgery, Therapeutics

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Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

Citació

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. Predictors of therapeutic failure in GH and prolactin co-secreting pituitary adenomas. _Endocrine Connections_. 2025. Vol. 14, núm. 7. [consulta: 27 de gener de 2026]. ISSN: 2049-3614. [Disponible a: https://hdl.handle.net/2445/222962]

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