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Prolactinomas and resistance to dopamine agonists
T Brue1, I Pellegrini, A Priou
1Service d'Endocrinologie et Maladies Métaboliques, Centre Hospitalier Universitaire Nord, Marseille, France.
Hormone Research
|January 1, 1992
Summary
Bromocriptine-resistant prolactinomas are severe pituitary tumors. A potent dopamine agonist, CV 205-502, normalized prolactin levels in only half of these difficult-to-treat patients.
Area of Science:
- Endocrinology
- Neurosurgery
- Oncology
Background:
- Prolactinoma is a common pituitary tumor.
- Bromocriptine is a first-line treatment, but resistance occurs.
- Resistant cases represent a severe disease aspect.
Purpose of the Study:
- To evaluate the efficacy of a potent dopamine agonist, CV 205-502, in bromocriptine-resistant prolactinoma patients.
- To assess treatment outcomes and disease progression in this cohort.
Main Methods:
- Retrospective analysis of 27 patients with bromocriptine-resistant prolactinoma.
- Treatment with dopamine agonists, including CV 205-502, alone or with surgery/radiation.
- Monitoring of plasma prolactin (PRL) levels and tumor growth.
Main Results:
- Half of the 24 patients treated with CV 205-502 achieved normal PRL levels.
- The remaining patients on CV 205-502 did not normalize PRL, and 4 experienced tumor growth.
- Severe outcomes included invasive tumor extensions and metastases in 3 patients.
Conclusions:
- Bromocriptine-resistant prolactinomas are challenging to manage.
- CV 205-502 shows efficacy in a subset of patients but is not universally effective.
- Management of resistant prolactinoma requires potent agents and potentially multimodal therapy.