Predictors of therapeutic failure in GH and prolactin co-secreting pituitary adenomas
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&am...
| Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2025 |
| País: | España |
| Institución: | Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO) |
| Repositorio: | r-FISABIO. Repositorio Institucional de Producción Científica |
| OAI Identifier: | oai:fisabio.fundanetsuite.com:p20113 |
| Acceso en línea: | https://fisabio.portalinvestigacion.com/publicaciones/20113 |
| Access Level: | acceso abierto |
| Palabra clave: | acromegaly somatostatin receptor ligands surgical remission growth hormone prolactin co-secreting pituitary adenoma |
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Predictors of therapeutic failure in GH and prolactin co-secreting pituitary adenomasAraujo-Castro, MBiagetti, BMenéndez, ENovoa-Testa, ICordido, FBerrocal, VRPascual-Corrales, EGuerrero-Pérez, FVicente, AGarcía-Centeno, RGonzalez, LGarcia, MDOEcharri, AIRodríguez, MDMNovo-Rodríguez, CCalatayud, MVillar-Taibo, RBernabéu, IAlvarez-Escola, CJimenez, CTAbellan-Galiana, PVenegas, EGonzález-Molero, IIglesias, PBlanco, CDe Lara, FVONovoa, MPDTorres, ELMHanzu, FLamas, CRodriguez, SAAulinas, ARecio, JMAviles-Pérez, MDNúñez, MASCamara, RFano, MPFajardo, CCardoso, LMarques, PMartínez-Sàez, ERuz-Caracuel, IMarazuela, MPuig-Domingo, Macromegalysomatostatin receptor ligandssurgical remissiongrowth hormoneprolactin co-secreting pituitary adenomaAim: 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.BIOSCIENTIFICA LTD2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fisabio.portalinvestigacion.com/publicaciones/20113Endocrine ConnectionsISSN: 20493614reponame:r-FISABIO. Repositorio Institucional de Producción Científicainstname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)Inglésinfo:eu-repo/semantics/openAccessoai:fisabio.fundanetsuite.com:p201132026-06-11T12:45:17Z |
| dc.title.none.fl_str_mv |
Predictors of therapeutic failure in GH and prolactin co-secreting pituitary adenomas |
| title |
Predictors of therapeutic failure in GH and prolactin co-secreting pituitary adenomas |
| spellingShingle |
Predictors of therapeutic failure in GH and prolactin co-secreting pituitary adenomas Araujo-Castro, M acromegaly somatostatin receptor ligands surgical remission growth hormone prolactin co-secreting pituitary adenoma |
| title_short |
Predictors of therapeutic failure in GH and prolactin co-secreting pituitary adenomas |
| title_full |
Predictors of therapeutic failure in GH and prolactin co-secreting pituitary adenomas |
| title_fullStr |
Predictors of therapeutic failure in GH and prolactin co-secreting pituitary adenomas |
| title_full_unstemmed |
Predictors of therapeutic failure in GH and prolactin co-secreting pituitary adenomas |
| title_sort |
Predictors of therapeutic failure in GH and prolactin co-secreting pituitary adenomas |
| dc.creator.none.fl_str_mv |
Araujo-Castro, M Biagetti, B Menéndez, E Novoa-Testa, I Cordido, F Berrocal, VR Pascual-Corrales, E Guerrero-Pérez, F Vicente, A García-Centeno, R Gonzalez, L Garcia, MDO Echarri, AI Rodríguez, MDM Novo-Rodríguez, C Calatayud, M Villar-Taibo, R Bernabéu, I Alvarez-Escola, C Jimenez, CT Abellan-Galiana, P Venegas, E González-Molero, I Iglesias, P Blanco, C De Lara, FVO Novoa, MPD Torres, ELM Hanzu, F Lamas, C Rodriguez, SA Aulinas, A Recio, JM Aviles-Pérez, MD Núñez, MAS Camara, R Fano, MP Fajardo, C Cardoso, L Marques, P Martínez-Sàez, E Ruz-Caracuel, I Marazuela, M Puig-Domingo, M |
| author |
Araujo-Castro, M |
| author_facet |
Araujo-Castro, M Biagetti, B Menéndez, E Novoa-Testa, I Cordido, F Berrocal, VR Pascual-Corrales, E Guerrero-Pérez, F Vicente, A García-Centeno, R Gonzalez, L Garcia, MDO Echarri, AI Rodríguez, MDM Novo-Rodríguez, C Calatayud, M Villar-Taibo, R Bernabéu, I Alvarez-Escola, C Jimenez, CT Abellan-Galiana, P Venegas, E González-Molero, I Iglesias, P Blanco, C De Lara, FVO Novoa, MPD Torres, ELM Hanzu, F Lamas, C Rodriguez, SA Aulinas, A Recio, JM Aviles-Pérez, MD Núñez, MAS Camara, R Fano, MP Fajardo, C Cardoso, L Marques, P Martínez-Sàez, E Ruz-Caracuel, I Marazuela, M Puig-Domingo, M |
| author_role |
author |
| author2 |
Biagetti, B Menéndez, E Novoa-Testa, I Cordido, F Berrocal, VR Pascual-Corrales, E Guerrero-Pérez, F Vicente, A García-Centeno, R Gonzalez, L Garcia, MDO Echarri, AI Rodríguez, MDM Novo-Rodríguez, C Calatayud, M Villar-Taibo, R Bernabéu, I Alvarez-Escola, C Jimenez, CT Abellan-Galiana, P Venegas, E González-Molero, I Iglesias, P Blanco, C De Lara, FVO Novoa, MPD Torres, ELM Hanzu, F Lamas, C Rodriguez, SA Aulinas, A Recio, JM Aviles-Pérez, MD Núñez, MAS Camara, R Fano, MP Fajardo, C Cardoso, L Marques, P Martínez-Sàez, E Ruz-Caracuel, I Marazuela, M Puig-Domingo, M |
| author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
| dc.subject.none.fl_str_mv |
acromegaly somatostatin receptor ligands surgical remission growth hormone prolactin co-secreting pituitary adenoma |
| topic |
acromegaly somatostatin receptor ligands surgical remission growth hormone prolactin co-secreting pituitary adenoma |
| description |
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. |
| publishDate |
2025 |
| dc.date.none.fl_str_mv |
2025 |
| dc.type.none.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
| format |
article |
| status_str |
publishedVersion |
| dc.identifier.none.fl_str_mv |
https://fisabio.portalinvestigacion.com/publicaciones/20113 |
| url |
https://fisabio.portalinvestigacion.com/publicaciones/20113 |
| dc.language.none.fl_str_mv |
Inglés |
| language_invalid_str_mv |
Inglés |
| dc.rights.none.fl_str_mv |
info:eu-repo/semantics/openAccess |
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openAccess |
| dc.publisher.none.fl_str_mv |
BIOSCIENTIFICA LTD |
| publisher.none.fl_str_mv |
BIOSCIENTIFICA LTD |
| dc.source.none.fl_str_mv |
Endocrine Connections ISSN: 20493614 reponame:r-FISABIO. Repositorio Institucional de Producción Científica instname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO) |
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Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO) |
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r-FISABIO. Repositorio Institucional de Producción Científica |
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r-FISABIO. Repositorio Institucional de Producción Científica |
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1869423244991266816 |
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15.811543 |