[1]张诚,王继超.难治性垂体腺瘤的药物治疗进展[J].中国临床神经外科杂志,2024,29(10):616-619.[doi:10.13798/j.issn.1009-153X.2024.10.010]
　ZHANG Cheng,WANG Ji-chao.Progress of drug therapy for refractory pituitary adenomas[J].,2024,29(10):616-619.[doi:10.13798/j.issn.1009-153X.2024.10.010]
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难治性垂体腺瘤的药物治疗进展()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
29
期数:
2024年10期
页码:
616-619
栏目:
综述
出版日期:
2024-10-30

文章信息/Info

Title:
Progress of drug therapy for refractory pituitary adenomas
文章编号:
1009-153X（2024）10-0616-04
作者:
张诚; 王继超
830000乌鲁木齐，新疆维吾尔自治区人民医院神经外科（张诚、王继超）
Author(s):
ZHANG Cheng;  WANG Ji-chao
Department of Neurosurgery, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi 830001, China
关键词:
垂体腺瘤; 难治性垂体腺瘤; 药物治疗
Keywords:
Pituitary adenoma;  Refractory pituitary adenoma;  Drug treatment
分类号:
R 739.41
DOI:
10.13798/j.issn.1009-153X.2024.10.010
文献标志码:
A
摘要:
垂体腺瘤是颅内常见的神经内分泌肿瘤，多数可通过手术、药物或放疗而治愈。然而，少部分垂体腺瘤呈侵袭性生长，生长速度较快，即使联合手术、药物及放疗等多种方法亦不能控制肿瘤进展，预后差，甚至导致病人死亡，称为难治性垂体腺瘤。其临床治疗是一大挑战，通常需要多模式治疗。随着对垂体腺瘤微环境研究的逐渐深入，化疗药物（如替莫唑胺、卡培他滨和依维莫司）的抗肿瘤作用、免疫治疗以及肽受体放射性核素治疗难治性垂体肿瘤的研究越来越多，此类病人的预后得到了极大的改善。本文就难治性垂体腺瘤的药物治疗进展进行综述，总结药物治疗及其疗效的全面信息，为临床提供参考。
Abstract:
Pituitary adenoma is a common neuroendocrine tumor in the brain. The majority can be cured via surgery, medication, or radiotherapy. Nevertheless, a small portion of pituitary adenomas exhibit invasive growth and a relatively rapid growth rate. Even when combined with multiple approaches such as surgery, medication, and radiotherapy, tumor progression cannot be controlled, leading to a poor prognosis and even patient mortality. These are referred to as refractory pituitary adenomas. The clinical treatment of such cases poses a significant challenge and typically requires multimodal therapy. Recently, as research on the microenvironment of pituitary adenomas has gradually deepened, an increasing number of studies have been conducted on the anti-tumor effects of chemotherapy drugs (such as temozolomide, capecitabine, and everolimus), immunotherapy, and peptide receptor radionuclide therapy for refractory pituitary tumors. The prognosis of these patients has been significantly improved. This article provides a review of the progress in drug treatment for refractory pituitary adenomas, summarizes comprehensive information regarding drug treatment and its efficacy, and offers a reference for clinical practice.

参考文献/References:

[1] RAVEROT G, BURMAN P, MCCORMACK A, et al. European Society of Endocrinology Clinical Practice Guidelines for the management of aggressive pituitary tumours and carcinomas [J]. Eur J Endocrinol, 2018, 178(1): G1-G24.
[2] ASIOLI S, RIGHI A, IOMMI M, et al. Validation of a clinicopathological score for the prediction of post-surgical evolution of pituitary adenoma: retrospective analysis on 566 patients from a tertiary care centre [J]. Eur J Endocrinol, 2019, 180(2): 127-134.
[3] GUARALDI F, ZOLI M, RIGHI A, et al. A practical algorithm to predict postsurgical recurrence and progression of pituitary neuroendocrine tumours (PitNET)s [J]. Clin Endocrinol (Oxf), 2020, 93(1): 36-43.
[4] YAMAMOTO M, NAKAO T, OGAWA W, et al. Aggressive Cushing's disease: molecular pathology and its therapeutic approach [J]. Front Endocrinol (Lausanne), 2021, 12: 650791.
[5] DAI C, SUN B, GUAN S, et al. Evolution of a refractory prolactinsecreting pituitary adenoma into a pituitary carcinoma: report of a challenging case and literature review [J]. BMC Endocr Disord, 2021, 21(1): 217.
[6] LOSA M, BOGAZZI F, CANNAVO S, et al. Temozolomide therapy in patients with aggressive pituitary adenomas or carcinomas [J]. J Neuro-Oncol, 2016, 126: 519-525.
[7] LIN AL, JONSSON P, TABAR V, et al. Marked response of a hypermutated acth-secreting pituitary carcinoma to ipilimumab and nivolumab [J]. J Clin Endocrinol Metab, 2018, 103(10): 3925-3930.
[8] DAI C, LIU X, FENG M, et al. From "aggressive" to "refractory": advances and controversies in the definition and classification of pituitary tumors [J]. Endocr Pract, 2020, 26(11): 1384-1386.
[9] ALTINOZ MA, OZPINAR A. Oxamate targeting aggressive cancers with special emphasis to brain tumors [J]. Biomed Pharmacother, 2022, 147: 112686.
[10] WHITELAW BC. How and when to use temozolomide to treat aggressive pituitary tumours [J]. Endocr Relat Cancer, 2019, 26(9): R545-R552.
[11] TRIFILETTI DM, DUTTA SW, LEE CC, et al. Pituitary tumor radiosurgery [J]. Prog Neurol Surg, 2019, 34: 149-158.
[12] WANG R, ZHOU C, MCCORMACK AI, et al. Editorial: refractory pituitary adenoma-current challenges and emerging treatments [J]. Front Endocrinol (Lausanne), 2022, 13: 868174.
[13] NIE D, XUE Y, FANG Q, et al. Immune checkpoints: therapeutic targets for pituitary tumors [J]. Dis Markers, 2021, 2021: 5300381.
[14] TADESSE S, CALDON EC, TILLEY W, et al. Cyclin-dependent kinase 2 inhibitors in cancer therapy: an update [J]. J Med Chem, 2019, 62(9): 4233-4251.
[15] WEIGAND I, KNOBLOCH L, FLITSCH J, et al. Impact of USP8 gene mutations on protein deregulation in cushing disease [J]. J Clin Endocrinol Metab, 2019, 104(7): 2535-2546.
[16] WANICHI IQ, DE PAULA MARIANI BM, FRASSETTO FP, et al. Cushing's disease due to somatic USP8 mutations: a systematic review and meta-analysis [J]. Pituitary, 2019, 22(4): 435-442.
[17] BUSSIES PL, RICHARDS EG, ROTZ SJ, et al. Targeted cancer treatment and fertility: effect of immunotherapy and small molecule inhibitors on female reproduction [J]. Reprod Biomed Online, 2022, 44(1): 81-92.
[18] ZHANG D, WAY JS, ZHANG X, et al. Effect of everolimus in treatment of aggressive prolactin-secreting pituitary adenomas [J]. J Clin Endocrinol Metab, 2019, 104(6): 1929-1936.
[19] ALSHAIKH OM, ASA SL, METE O, et al. An institutional experience of tumor progression to pituitary carcinoma in a 15-year cohort of 1055 consecutive pituitary neuroendocrine tumors [J]. Endocr Pathol, 2019, 30(2): 118-127.
[20] GORVIN CM, NEWEY PJ, ROGERS A, et al. Association of prolactin receptor (PRLR) variants with prolactinomas [J]. Hum Mol Genet, 2019, 28(6): 10 23-1037.
[21] ZHANG D, WAY JS, ZHANG X, et al. Effect of everolimus in treatment of aggressive prolactin-secreting pituitary adenomas [J]. J Clin Endocrinol Metab, 2019, 104(6): 1929-1936.
[22] MARQUES P, SILVA AL, LOPEZ-PRESA D, et al. The microenvironment of pituitary adenomas: biological, clinical and therapeutical implications [J]. Pituitary, 2022, 25(3): 363-382.
[23] ROTMAN LE, VAUGHAN TB, HACKNEY JR, et al. Long-term survival after transformation of an adrenocorticotropic hormonesecreting pituitary macroadenoma to a silent corticotroph pituitary carcinoma [J]. World Neurosurg, 2019, 122: 417-423.
[24] DARVIN P, TOOR SM, SASIDHARAN NAIR V, et al. Immune checkpoint inhibitors: recent progress and potential biomarkers [J]. Exp Mol Med, 2018, 50(12): 1-11.
[25] CARLINO MS, LARKIN J, LONG GV. Immune checkpoint inhibitors in melanoma [J]. Lancet, 2021, 398(10304): 1002-1014.
[26] SOL B, DE FILETTE JMK, AWADA G, et al. Immune checkpoint inhibitor therapy for ACTH-secreting pituitary carcinoma: a new emerging treatment [J]? Eur J Endocrinol, 2021, 184(1): K1-K5.
[27] FERRARI SM, FALLAHI P, GALETTA F, et al. Thyroid disorders induced by checkpoint inhibitors [J]. Rev Endocr Metab Disord， 2018, 19(4): 325-333.
[28] BARROSO-SOUSA R, BARRY WT, GARRIDO-CASTRO AC, et al. Incidence of endocrine dysfunction following the use of different immune checkpoint inhibitor regimens: a systematic review and meta-analysis [J]. JAMA Oncol, 2018, 4(2): 173-182.
[29] TIAN Y, ABU-SBEIH H, WANG Y. Immune checkpoint inhibitorsinduced hepatitis [J]. Adv Exp Med Biol, 2018, 995: 159-164.
[30] DUHAMEL C, ILIE MD, SALLE H, et al. Immunotherapy in corticotroph and lactotroph aggressive tumors and carcinomas: two case reports and a review of the literature [J]. J Pers Med, 2020, 10(3): 88.
[31] TAN MH, IYENGAR R, MIZOKAMI-STOUT K, et al. Spectrum of immune checkpoint inhibitors-induced endocrinopathies in cancer patients: a scoping review of case reports [J]. Clin Diabetes Endocrinol, 2019, 5: 1.

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备注/Memo

备注/Memo:
（2022-09-07收稿，2024-04-21修回）
基金项目：新疆维吾尔自治区自然科学基金（2023D01C62）；国家自然科学基金（82060316）
通信作者：王继超，Email：xjsjwk@sina.com
更新日期/Last Update: 2024-10-30