Pituitary-directed therapies for Cushing's disease

Fabienne Langlois, Jennifer Chu, Maria Fleseriu

Research output: Contribution to journalReview article

9 Citations (Scopus)

Abstract

Cushing's disease (CD) is caused by a pituitary corticotroph neuroendocrine tumor inducing uncontrolled hypercortisolism. Transsphenoidal surgery is the first-line treatment in most cases. Nonetheless, some patients will not achieve cure even in expert hands, others may not be surgical candidates and a significant percentage will experience recurrence. Many patients will thus require medical therapy to achieve disease control. Pharmacologic options to treat CD have increased in recent years, with an explosion in knowledge related to pathophysiology at the molecular level. In this review, we focus on medications targeting specifically pituitary adrenocorticotropic hormone-secreting tumors. The only medication in this group approved for the treatment of CD is pasireotide, a somatostatin receptor ligand. Cabergoline and temozolomide may also be used in select cases. Previously studied and abandoned medical options are briefly discussed, and emphasis is made on upcoming medications. Mechanism of action and available data on efficacy and safety of cell cycle inhibitor roscovitine, epidermal growth factor receptor inhibitor gefitinib, retinoic acid, and silibinin, a heat shock protein 90 inhibitor are also presented.

Original languageEnglish (US)
Article number164
JournalFrontiers in Endocrinology
Volume9
Issue numberMAY
DOIs
StatePublished - May 1 2018

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Pituitary ACTH Hypersecretion
temozolomide
Corticotrophs
HSP90 Heat-Shock Proteins
Somatostatin Receptors
Pituitary Hormones
Neuroendocrine Tumors
Cushing Syndrome
Explosions
Tretinoin
Epidermal Growth Factor Receptor
Adrenocorticotropic Hormone
Cell Cycle
Therapeutics
Hand
Ligands
Safety
Recurrence
Neoplasms

Keywords

  • Adrenocorticotropic hormone-secreting adenoma
  • Cabergoline
  • Cushing's disease
  • Gefitinib
  • Hypercortisolemia
  • Pasireotide
  • Retinoic acid
  • Roscovitine

ASJC Scopus subject areas

  • Endocrinology, Diabetes and Metabolism

Cite this

Pituitary-directed therapies for Cushing's disease. / Langlois, Fabienne; Chu, Jennifer; Fleseriu, Maria.

In: Frontiers in Endocrinology, Vol. 9, No. MAY, 164, 01.05.2018.

Research output: Contribution to journalReview article

Langlois, Fabienne ; Chu, Jennifer ; Fleseriu, Maria. / Pituitary-directed therapies for Cushing's disease. In: Frontiers in Endocrinology. 2018 ; Vol. 9, No. MAY.
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