Elucidating Clinical Queries for Tailored Therapy in Patients with Prolactinoma
Prolactinomas are the most prevalent type of pituitary neuroendocrine adenomas, primarily affecting women of reproductive age. Unlike other pituitary tumors, the first-line management has traditionally been pharmacological rather than surgical. This preference is due to the effectiveness of dopamine...
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Korean Endocrine Society
2024-12-01
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| Series: | Endocrinology and Metabolism |
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| Online Access: | http://www.e-enm.org/upload/pdf/enm-2024-2057.pdf |
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| author | Min-Ho Lee Jae Won Hong Kyungwon Kim Cheol Ryong Ku Eun Jig Lee |
| author_facet | Min-Ho Lee Jae Won Hong Kyungwon Kim Cheol Ryong Ku Eun Jig Lee |
| author_sort | Min-Ho Lee |
| collection | DOAJ |
| description | Prolactinomas are the most prevalent type of pituitary neuroendocrine adenomas, primarily affecting women of reproductive age. Unlike other pituitary tumors, the first-line management has traditionally been pharmacological rather than surgical. This preference is due to the effectiveness of dopamine agonists (DAs), which typically reduce tumor size and normalize prolactin levels in most patients. However, this does not imply that there is no room for improvement; the duration of treatment and medication side effects often lead to compliance issues among patients. Recent advances in surgical techniques and molecular biology have paved the way for the development of precision medicine, allowing for more flexible and personalized treatment strategies for prolactinomas. This review aims to enhance clinical decision-making and patient care for endocrinologists by focusing on several key factors: predictive markers of DA sensitivity, clinical characteristics and suitability for transsphenoidal adenomectomy as a potential first-line treatment, factors determining the successful withdrawal of DAs after prolonged use, safety concerns during pre/post-pregnancy and breastfeeding, and determinants of tumor aggressiveness. Through tailored therapy—a patient-focused, multidisciplinary approach— we aim to improve the management of prolactinoma patients. |
| format | Article |
| id | doaj-art-e9f5da5f4c9c4638b971ba71b113463d |
| institution | Kabale University |
| issn | 2093-596X 2093-5978 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Korean Endocrine Society |
| record_format | Article |
| series | Endocrinology and Metabolism |
| spelling | doaj-art-e9f5da5f4c9c4638b971ba71b113463d2025-01-03T05:15:26ZengKorean Endocrine SocietyEndocrinology and Metabolism2093-596X2093-59782024-12-0139681982610.3803/EnM.2024.20572535Elucidating Clinical Queries for Tailored Therapy in Patients with ProlactinomaMin-Ho Lee0Jae Won Hong1Kyungwon Kim2Cheol Ryong Ku3Eun Jig Lee4 University of Medicine and Health Sciences, New York, NY, USA Department of Internal Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea Division of Endocrinology, Department of Internal Medicine, Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Korea Division of Endocrinology, Department of Internal Medicine, Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, Korea Division of Endocrinology, Department of Internal Medicine, Institute of Endocrine Research, Yonsei University College of Medicine, Seoul, KoreaProlactinomas are the most prevalent type of pituitary neuroendocrine adenomas, primarily affecting women of reproductive age. Unlike other pituitary tumors, the first-line management has traditionally been pharmacological rather than surgical. This preference is due to the effectiveness of dopamine agonists (DAs), which typically reduce tumor size and normalize prolactin levels in most patients. However, this does not imply that there is no room for improvement; the duration of treatment and medication side effects often lead to compliance issues among patients. Recent advances in surgical techniques and molecular biology have paved the way for the development of precision medicine, allowing for more flexible and personalized treatment strategies for prolactinomas. This review aims to enhance clinical decision-making and patient care for endocrinologists by focusing on several key factors: predictive markers of DA sensitivity, clinical characteristics and suitability for transsphenoidal adenomectomy as a potential first-line treatment, factors determining the successful withdrawal of DAs after prolonged use, safety concerns during pre/post-pregnancy and breastfeeding, and determinants of tumor aggressiveness. Through tailored therapy—a patient-focused, multidisciplinary approach— we aim to improve the management of prolactinoma patients.http://www.e-enm.org/upload/pdf/enm-2024-2057.pdfprolactinomaprecision medicineclinical decision-making |
| spellingShingle | Min-Ho Lee Jae Won Hong Kyungwon Kim Cheol Ryong Ku Eun Jig Lee Elucidating Clinical Queries for Tailored Therapy in Patients with Prolactinoma Endocrinology and Metabolism prolactinoma precision medicine clinical decision-making |
| title | Elucidating Clinical Queries for Tailored Therapy in Patients with Prolactinoma |
| title_full | Elucidating Clinical Queries for Tailored Therapy in Patients with Prolactinoma |
| title_fullStr | Elucidating Clinical Queries for Tailored Therapy in Patients with Prolactinoma |
| title_full_unstemmed | Elucidating Clinical Queries for Tailored Therapy in Patients with Prolactinoma |
| title_short | Elucidating Clinical Queries for Tailored Therapy in Patients with Prolactinoma |
| title_sort | elucidating clinical queries for tailored therapy in patients with prolactinoma |
| topic | prolactinoma precision medicine clinical decision-making |
| url | http://www.e-enm.org/upload/pdf/enm-2024-2057.pdf |
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