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Preclinical and clinical experiences with the role of dopamine receptors in the treatment of pituitary adenomas

Department of Endocrinological and Medical Sciences and Center of Excellence for Biomedical Research, University of Genova, Genova, Italy, ¹ Department of Molecular and Clinical Endocrinology and Oncology ‘Federico II’ University, Naples, Italy and ² Biomeasure Inc./IPSEN, Milford, Massachusetts, USA

(Correspondence should be addressed to Diego Ferone; Email: ferone{at}unige.it)

This paper was presented at a symposium held at the Erasmus Medical Center, Rotterdam, The Netherlands, 2005. The symposium was jointly organized by LJ Hofland, Erasmus Medical Center, and A Colao, Federico II University of Naples, Italy. Ipsen partially supported the publication of these proceedings.

Abstract

Pituitary tumors can cause symptoms of mass effect and hormonal hypersecretion that can be reversed with surgical resection or debulking of the adenoma, radiotherapy, or medical treatment. Medical treatment is the primary choice for prolactinomas because dopamine agonists are very effective in the treatment of these tumors, with rates of control (tumor size reduction and hormone suppression) as high as 80–90% for microprolactinomas and 60–75% for macroprolactinomas. The function of dopamine receptors in other histotypes of pituitary adenoma is still debated. However, new insights into receptor physiology and the introduction of new clinically available, as well as experimental, compounds have reopened a potential role of dopaminergic drugs in the medical treatment of pituitary tumors. The differences between the effectiveness and the resistance to different dopaminergic agents, the new challenging results from clinical and experimental studies, as well as the future of dopamine agonists in the therapy of pituitary tumors are discussed.