What’s New in Pituitary Tumor Research?

Research into pituitary tumors is being done in many medical centers and other institutions around the world.

Research on pituitary tumor genetics and classification

Doctors now better understand the gene changes in cells that can lead to pituitary tumors.

This is already leading to improvements in genetic testing for people who are suspected of having multiple endocrine neoplasia, type I (MEN1) or other inherited syndromes that increase the risk of pituitary tumors.

Understanding the gene and protein changes inside tumor cells is also helping doctors better classify pituitary adenomas, as well as better customize treatments for people with these tumors.

This type of research might also make it possible to identify specific gene changes and biomarkers in a person's tumor cells. This could help doctors know, for example, whether a pituitary adenoma is more likely to grow aggressively or to come back after treatment, which in turn might affect a person’s treatment options.

Research on imaging tests for pituitary tumors

Imaging tests such as MRI scans continue to improve, leading to better accuracy in finding and determining the size of new tumors and those that come back after treatment. Studies are now looking at whether using MRI during surgery (known as intraoperative MRI) might help ensure tumors are removed completely.

Other types of imaging tests, such as newer types of PET scans, are also being studied in clinical trials.

Research on pituitary tumor treatments

Doctors are looking for better ways to treat pituitary tumors while causing fewer side effects.

Surgery 

Surgery is often used to treat pituitary tumors. Doctors continue to look for better ways to remove these tumors completely while sparing as much of the normal pituitary gland as possible.

Pituitary surgery often uses minimally invasive techniques, with a tiny video camera on the end of a small, flexible scope (an endoscope) and very small, thin surgical tools (microinstruments). This can mean shorter recovery times for the patient after surgery, as well as better nasal outcomes, fewer hormone issues, and a better quality of life.

Studies are now looking at which type of surgery might be best for different types and sizes of tumors, as well as ways to combine surgical techniques or use 2-staged surgery to get better results. 

Another technological advance in pituitary surgery is neuronavigation, in which surgical tools are ‘attached’ virtually to preoperative MRI or CT images so neurosurgeons can see the exact position of the tools in relation to the tumor, as well as important surrounding structures. This can be thought of as being a type of GPS for the base of the skull and brain.

Robotic surgery, in which the surgeon sits at a control panel and precisely moves robotic arms, is also being studied as a way to reach these tumors and limit side effects. 

Radiation therapy

Radiation therapy techniques are improving, letting doctors focus radiation more precisely on tumors and limiting the damage to nearby normal tissues.

Doctors are also studying whether giving radiation after surgery helps keep pituitary tumors from coming back.

Medicines

Progress is being made in the medicines used to treat pituitary tumors and in those used to help relieve the side effects of some other forms of treatment.

For example, researchers are studying some newer drugs:

• TBR-760 is a combined dopamine-somatostatin receptor agonist, so it can affect pituitary cells in more than one way. This drug is now being studied for use against non-functioning pituitary adenomas.
• Vorinostat is a type of drug known as a histone deacetylase (HDAC) inhibitor. It affects which genes a tumor cell is using. This drug is already used to treat some uncommon types of lymphomas, and is now being studied for use against ACTH-secreting pituitary adenomas.

Other drugs are also being studied in clinical trials.