[Clinical practice considerations on cabergoline in the treatment of pituitary prolactinoma]

Prolactinoma, the most common functional pituitary neuroendocrine tumor, belongs to Pit-1 lineage of pituitary neuroendocrine tumors. The treatment methods include surgery, medication, and radiation therapy, with drug therapy centered around dopamine receptor agonists. Cabergoline, a selective D2 receptor agonist with high receptor affinity and long-acting properties, is recommended as a first-line treatment in international guidelines for prolactinoma management.Based on the 2014 edition, the "Consensus on the diagnosis and treatment of pituitary prolactinoma (2025 edition)" has made important updates to the treatment recommendations for cabergoline, mainly including: For patients with bromocriptine resistance, if cabergoline is available, switching to cabergoline is recommended as the first choice; For patients receiving long-term, high-dose cabergoline treatment, regular echocardiogram monitoring is recommended to assess the condition of heart valves. Meanwhile, it also provides more detailed elaborations on cabergoline's efficacy, adverse reactions (such as heart valve disease, impulse control disorders, etc.), and its application in drug-resistant prolactinomas. However, since cabergoline has not yet been marketed in Chinese mainland, the practical clinical experience with this drug in the domestic setting remains relatively limited, and there is a lack of systematic summary of local data. Endocrinologists need to pay special attention to the selection of its indications, efficacy evaluation, and safety monitoring during long-term medication.