The molecular pathogenesis of pituitary tumors: implications for clinical management.
Pituitary adenomas are unique in several ways, and while they are rarely malignant they may be invasive and/or recurrent. Several attempts have been made to determine the growth potential of pituitary adenomas. Pituitary tumors predominantly arise in a sporadic setting or more rarely as part of hereditary genetic syndromes. Molecular analysis of these familial pituitary adenomas has provided significant insight into pituitary tumorigenesis. Some specific genes have been identified that predispose to pituitary neoplasia, but these are rarely involved in the pathogenesis of sporadic tumors. The number of genes or molecular alterations involved in pituitary tumorigenesis is progressively increasing, providing a hope for development of new predictive and prognostic markers. The aim of this review is to focus on the molecular pathology of pituitary adenomas in the context of their implications on management and targeted therapy. We have summarized our current knowledge on the molecular biology in familial and sporadic pituitary adenomas, and we subsequently focus on prognostic factors as well as specific predictive markers for new promising targeted therapies.
Department of Endocrinology, King's College Hospital, Denmark Hill, London, UK.
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Dworakowska
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Grossman
D000236:Adenoma / Q000235:genetics* / Q000378:metabolism / Q000628:therapy; D000970:Antineoplastic Agents / Q000494:pharmacology / Q000627:therapeutic use; D017209:Apoptosis; D014408:Biomarkers, Tumor; D002277:Carcinoma / Q000235:genetics / Q000378:metabolism / Q000628:therapy; D002471:Cell Transformation, Neoplastic / Q000235:genetics; D003131:Combined Modality Therapy; D019468:Disease Management; D052138:Genes, Neoplasm; D006801:Humans; D007016:Hypophysectomy; D058990:Molecular Targeted Therapy; D009363:Neoplasm Proteins / Q000037:antagonists & inhibitors / Q000235:genetics / Q000502:physiology; D009386:Neoplastic Syndromes, Hereditary / Q000235:genetics; D010907:Pituitary Hormones / Q000378:metabolism; D010911:Pituitary Neoplasms / Q000235:genetics* / Q000378:metabolism / Q000628:therapy; D011379:Prognosis; D015398:Signal Transduction / Q000235:genetics
D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D009363:Neoplasm Proteins; D010907:Pituitary Hormones