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Predictors of therapeutic failure in GH and prolactin co-secreting pituitary adenomas

2025-07-15Research article Open access
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dc.contributor.authorAraujo-Castro, Marta
dc.contributor.authorBiagetti, Betina
dc.contributor.authorMenéndez, Edelmiro
dc.contributor.authorNovoa-Testa, Iría
dc.contributor.authorCordido, Fernando
dc.contributor.authorBerrocal, Víctor Rodríguez
dc.contributor.authorPascual-Corrales, Eider
dc.contributor.authorGuerrero-Pérez, Fernando
dc.contributor.authorVicente, Almudena
dc.contributor.authorGarcía-Centeno, Rogelio
dc.contributor.authorGonzález, Laura
dc.contributor.authorGarcía, María Dolores Ollero
dc.contributor.authorEcharri, Ana Irigaray
dc.contributor.authorRodríguez, María Dolores Moure
dc.contributor.authorNovo-Rodríguez, Cristina
dc.contributor.authorCalatayud, María
dc.contributor.authorVillar-Taibo, Rocío
dc.contributor.authorBernabéu, Ignacio
dc.contributor.authorAlvarez-Escola, Cristina
dc.contributor.authorJimenéz, Carmen Tenorio
dc.contributor.authorAbellán-Galiana, Pablo
dc.contributor.authorVenegas, Eva
dc.contributor.authorGonzález-Molero, Inmaculada
dc.contributor.authorIglesias, Pedro
dc.contributor.authorBlanco, Concepción
dc.contributor.authorLara, Fernando Vidal Ostos de
dc.contributor.authorNovoa, María Paz de Miguel
dc.contributor.authorTorres, Elena López Mezquita
dc.contributor.authorHanzu, Felicia
dc.contributor.authorLamas, Cristina
dc.contributor.authorRodríguez, Silvia Aznar
dc.contributor.authorAulinas, Anna
dc.contributor.authorRecio, José María
dc.contributor.authorAviles-Pérez, María Dolores
dc.contributor.authorNúñez, Miguel Antonio Sampedro
dc.contributor.authorCamara, Rosa
dc.contributor.authorFano, Miguel Paja
dc.contributor.authorFajardo, Carmen
dc.contributor.authorCardoso, Luís
dc.contributor.authorMarques, Pedro
dc.contributor.authorMartínez-Sáez, Elena
dc.contributor.authorRuz-Caracuel, Ignacio
dc.contributor.authorMarazuela, Mónica
dc.contributor.authorPuig-Domingo, Manel
dc.date.accessioned2025-08-13T09:42:25Z
dc.date.available2025-08-13T09:42:25Z
dc.date.issued2025-07-15
dc.description.abstractAim: 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.eng
dc.identifier.doi10.1530/EC-25-0103
dc.identifier.eid105012021956
dc.identifier.other71b22915-e0fe-4c0c-b26f-9eec9916d6cc
dc.identifier.pmcPMC12268987
dc.identifier.pmid40590355
dc.identifier.urihttp://hdl.handle.net/10400.14/54495
dc.language.isoeng
dc.peerreviewedyes
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectAcromegaly
dc.subjectGrowth hormone
dc.subjectProlactin co-secreting pituitary adenoma
dc.subjectSomatostatin receptor ligands
dc.subjectSurgical remission
dc.titlePredictors of therapeutic failure in GH and prolactin co-secreting pituitary adenomaseng
dc.typeresearch article
dspace.entity.typePublication
oaire.citation.issue7
oaire.citation.titleEndocrine Connections
oaire.citation.volume14
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85

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