Table 1.
Future therapeutic options for aggressive prolactinoma based on the available evidence.
| Place of Action | Evidence (References) | Clinical Trials | |
|---|---|---|---|
| Capecitabine and Temozolomide in firstline | MGMT inhibits DNA synthesis and slows growth of tumour tissue |
Isolated human case reports summarised in [86] | Ongoing NCT03930771 for functional and non-functional aggressive pituitary tumours |
| Pasireotide | multireceptor ligand SSTR5 > SSTR2 > SSTR3 > SSTR1 |
Case reports (humans) [62,63] | No |
| Atiprimod | JAK2-STAT → STAT3 | rat cell lines GH3 [83] | No |
| 5-fluorocytosine, nortriptyline, neratinib, taxifolin, vorinostat, zileuton | PI3K-Akt-mTOR | MMQ cell lines and mRNA-miRNA data integration [84] | No |
| Everolimus | prolactinoma derived cells (human) [44] Case reports (humans) [85] |
No | |
| Blockade of MAPK14 | MAPK/AMPK | mice and human prolactinoma cells [87] | No |
| Metformin | prolactinoma derived cells (human) [8] | No. A pilot study (n = 10) failed to show PRL normalisation (no data on tumour growth) | |
| Raloxifene | oestrogen receptor modulator | case reports (humans) [94] | Pilot study (n = 14), not randomised, no control group |
| Immunotherapy | PD-L1 PIT-1 | case reports (humans) [95] | No |
| Ipilimumab and nivolumab | Progressive pituitary adenoma/carcinoma NCT04042753 and NCT02834013 |