What are the drug treatments for pituitary tumors

After many patients are diagnosed with pituitary tumors, doctors will recommend surgical treatment from a professional perspective. However, many patients are unwilling to undergo surgical treatment. They cannot accept surgery on their heads and want to only receive drug treatment. What are the drug treatments for pituitary tumors?

The clinical application of drug treatment for pituitary adenomas is more mature in PRL tumors and GH tumors. A class of dopamine D2 receptor agonists represented by bromocriptine has become the first choice for the treatment of PRL tumors. The efficacy of drug treatment for other adenomas is still uncertain, and mainly relies on surgical resection and radiotherapy. Drug treatment is mainly suitable for patients with surgical contraindications or those who need adjuvant treatment before and after surgery. The following mainly focuses on dopamine agonists, somatostatin analogs, and GH receptor antagonists.

(1) Bromocriptine is a semi-synthetic derivative of ergot alkaloids. It is a dopamine receptor agonist that can effectively inhibit the secretion of PRL and partially inhibit the release of GH. After taking the drug for 2 weeks, female patients can reduce galactorrhea, and normal menstruation can be restored after about 2 months of medication. Ovulation and conception can also be achieved. After taking the drug for 3 months, the blood testosterone concentration of male patients increases, and returns to normal within 1 year. The number of sperm increases. Bromocriptine can not only reduce PRL levels, but also shrink tumors, relieve patients' headaches, and improve visual field defects. The disadvantage of bromocriptine is that the tumor is prone to recurrence after discontinuation of the drug. Its side effects are relatively mild, including nausea, vomiting, fatigue, orthostatic hypotension, etc. As long as the patient is not allergic to bromocriptine and can tolerate it, it is suitable for any PRL tumor patient, and it can also be used for patients with high PRL blood caused by other reasons.

(2) Somatostatin analogs. Somatostatin analogs mainly play a role in the following stages: ①. First-choice treatment: Suitable for patients with complications, severe metabolic disorders, who are not suitable for surgery or who are afraid of surgery. ②. Preoperative treatment: The purpose is to reduce the size of the tumor, create conditions for complete surgical removal of the tumor, and improve the efficacy of surgery. ③. Postoperative adjuvant therapy: Suitable for patients whose GH levels still do not meet the standard after surgery. ④. Transitional treatment after radiotherapy: GH levels decrease slowly after radiotherapy. During this period, somatostatin analogs can be used as transitional treatment. ⑤. Treatment of complications: growth hormone receptor antagonists.

(3) GH receptor antagonists are a new class of drugs used in recent years to treat GH adenoma, and the representative drug is Pegvisomant. Its affinity for GH receptors is higher than that of GH, and its half-life is also longer. It mainly works by competing with GH to bind to GH receptors. Existing experimental results have shown that subcutaneous injection of 15-20 mg/d of Pegvisomant can restore serum IGF-I to normal in 75-80% of GH adenoma patients in a dose-dependent manner. In addition, it is currently mainly used for surgical treatment of patients with poor radiotherapy results. However, there are also reports that this drug can cause asymptomatic liver cell damage in patients, and cause GH antibodies and Pegvisomant antibodies in 1/5 of patients. As a new drug, the exact dosage effect and safety of Pegvisomant need further observation.

Whether it is drug treatment or other treatment methods, our goal is to treat pituitary tumors, prevent tumor recurrence, and prevent and deal with complications. Therefore, when seeing a doctor, you need to follow the doctor's advice on what treatment method to choose, because everyone's condition and physical condition are different, and it depends on the situation.