在PRL和GH共分泌与GH分泌的Pit-NET中,佩格维索曼特和沙雷胺
Marta Araujo-Castro1, Betina Biagetti2, Edelmiro Menéndez Torre3
1Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, Madrid, Spain & Instituto de Investigación Biomédica Ramón y Cajal (IRYCIS), Madrid, Spain.
Endocrine-related cancer
|May 7, 2024
概括
二线疗法,如沙雷胺和佩格维索曼特有效控制生长激素 (GH) 和前列腺素 (PRL) 在垂体瘤. 这些治疗方法在患有GH分泌瘤的壮病患者中表现出类似的疗效,而不是那些同时分泌GH和PRL瘤的患者.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 神经科学是一个神经科学.
背景情况:
- 巨症通常是由生长激素 (GH) 分泌的垂体神经内分泌瘤 (Pit-NETs) 引起的.
- 一些Pit-NETs共同分泌GH和益生菌素 (PRL),这带来了独特的临床挑战.
- 二线治疗对于管理对初级治疗反应不足的患者至关重要.
研究的目的:
- 为了比较沙雷胺和佩格维索曼特在患有GH分泌Pit-NETs和GH和PRL共分泌Pit-NETs (GH&PRL-Pit-NETs) 的斑症患者中的疗效.
- 评估这些疗法的有效性,以使胰岛素类生长因子1 (IGF-1) 和PRL水平正常化.
主要方法:
- 一项多中心的回顾性研究,涉及150名壮病患者,接受了沙利西和/或佩格维索曼特治疗.
- 根据荷尔蒙分泌和免疫组织化学,患者被分为GH&PRL-Pit-NETs (n=28) 或GH-Pit-NETs (n=122) 组.
- 通过IGF-1正常化率和PRL水平控制来评估有效性.
主要成果:
- 与GH&PRL-Pit-NETs相比,GH&PRL-Pit-NETs与诊断时的年轻年龄,较高的hypopituitarism率和增加的入侵性有关.
- 总体上,IGF-1正常化率为佩格维索曼特的81.5%,而佩格维索曼特的71.4%.
- 在GH&PRL-Pit-NETs和GH-Pit-NETs之间没有观察到对IGF-1控制的显著差异,无论是 pasireotide还是 pegvisomant.
- 在所有接受治疗的GH&PRL-Pit-NET病例中 (n=6),帕西雷奥提德正常化的PRL,在接受治疗的GH&PRL-Pit-NET病例中,82.6% (n=19/23) 的佩格维索曼特正常化的PRL.
结论:
- 尽管GH&PRL-Pit-NET具有更具攻击性的行为,但与GH-Pit-NET相比,GH&PRL-Pit-NET对IGF-1控制的反应与 pasireotide和pegvisomant相似.
- 化和维索曼都是一种有效的二线疗法,用于控制IGF-1和PRL高分泌在患有这些瘤类型的壮病患者中.
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