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Eui-Hyun Kim  (Kim EH) 1 Article
Adrenal gland
Early Prediction of Long-Term Response to Cabergoline in Patients with Macroprolactinomas
Youngki Lee, Cheol Ryong Ku, Eui-Hyun Kim, Jae Won Hong, Eun Jig Lee, Sun Ho Kim
Endocrinol Metab. 2014;29(3):280-292.   Published online September 25, 2014
DOI: https://doi.org/10.3803/EnM.2014.29.3.280
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  • 12 Web of Science
  • 13 Crossref
AbstractAbstract PDFPubReader   
Background

Cabergoline is typically effective for treating prolactinomas; however, some patients display cabergoline resistance, and the early characteristics of these patients remain unclear. We analyzed early indicators predicting long-term response to cabergoline.

Methods

We retrospectively reviewed the cases of 44 patients with macroprolactinomas who received cabergoline as first-line treatment; the patients were followed for a median of 16 months. The influence of various clinical parameters on outcomes was evaluated.

Results

Forty patients (90.9%) were treated medically and displayed tumor volume reduction (TVR) of 74.7%, a prolactin normalization (NP) rate of 81.8%, and a complete response (CR; TVR >50% with NP, without surgery) rate of 70.5%. Most patients (93.1%) with TVR ≥25% and NP at 3 months eventually achieved CR, whereas only 50% of patients with TVR ≥25% without NP and no patients with TVR <25% achieved CR. TVR at 3 months was strongly correlated with final TVR (R=0.785). Patients with large macroadenomas exhibited a low NP rate at 3 months, but eventually achieved TVR and NP rates similar to those of patients with smaller tumors. Surgery independently reduced the final dose of cabergoline (β=-1.181 mg/week), and two of four patients who underwent surgery were able to discontinue cabergoline.

Conclusion

Determining cabergoline response using TVR and NP 3 months after treatment is useful for predicting later outcomes. However, further cabergoline administration should be considered for patients with TVR >25% at 3 months without NP, particularly those with huge prolactinomas, because a delayed response may be achieved. As surgery can reduce the cabergoline dose necessary for successful disease control, it should be considered for cabergoline-resistant patients.

Citations

Citations to this article as recorded by  
  • Resistance to dopamine agonists in the treatment of prolactinomas: diagnostic criteria, mechanisms and ways to overcome it
    Irena A. Ilovayskaya, Gulnar R. Vagapova
    Almanac of Clinical Medicine.2024; 51(7): 397.     CrossRef
  • Diagnosis and management of prolactin-secreting pituitary adenomas: a Pituitary Society international Consensus Statement
    Stephan Petersenn, Maria Fleseriu, Felipe F. Casanueva, Andrea Giustina, Nienke Biermasz, Beverly M. K. Biller, Marcello Bronstein, Philippe Chanson, Hidenori Fukuoka, Monica Gadelha, Yona Greenman, Mark Gurnell, Ken K. Y. Ho, Jürgen Honegger, Adriana G.
    Nature Reviews Endocrinology.2023; 19(12): 722.     CrossRef
  • Outcome Measures for Medical and Surgical Treatment of Prolactinomas. Is the Role of Surgery Underestimated?
    Andrius Anuzis, Kevin O. Lillehei
    Journal of Neurological Surgery Part B: Skull Base.2023;[Epub]     CrossRef
  • Are dopamine agonists still the first-choice treatment for prolactinoma in the era of endoscopy? A systematic review and meta-analysis
    Xiangming Cai, Junhao Zhu, Jin Yang, Chao Tang, Zixiang Cong, Chiyuan Ma
    Chinese Neurosurgical Journal.2022;[Epub]     CrossRef
  • Italian Association of Clinical Endocrinologists (AME) and International Chapter of Clinical Endocrinology (ICCE). Position statement for clinical practice: prolactin-secreting tumors
    Renato Cozzi, Maria Rosaria Ambrosio, Roberto Attanasio, Claudia Battista, Alessandro Bozzao, Marco Caputo, Enrica Ciccarelli, Laura De Marinis, Ernesto De Menis, Marco Faustini Fustini, Franco Grimaldi, Andrea Lania, Giovanni Lasio, Francesco Logoluso, M
    European Journal of Endocrinology.2022; 186(3): P1.     CrossRef
  • Biochemical Remission after Cabergoline Withdrawal in Hyperprolactinemic Patients with Visible Remnant Pituitary Adenoma
    Kyungwon Kim, Yae Won Park, Daham Kim, Sung Soo Ahn, Ju Hyung Moon, Eui Hyun Kim, Eun Jig Lee, Cheol Ryong Ku
    The Journal of Clinical Endocrinology & Metabolism.2021; 106(2): e615.     CrossRef
  • Surgery is a safe, effective first-line treatment modality for noninvasive prolactinomas
    Ji Yong Park, Wonsuk Choi, A Ram Hong, Jee Hee Yoon, Hee Kyung Kim, Woo-Youl Jang, Shin Jung, Ho-Cheol Kang
    Pituitary.2021; 24(6): 955.     CrossRef
  • Molecular Pathways in Prolactinomas: Translational and Therapeutic Implications
    Betina Biagetti, Rafael Simò
    International Journal of Molecular Sciences.2021; 22(20): 11247.     CrossRef
  • A scoping review to understand the indications, effectiveness, and limitations of cabergoline in radiological and biochemical remission of prolactinomas
    Rakesh Mishra, SubhasK Konar, Adesh Shrivastava, Pradeep Chouksey, Sumit Raj, Amit Agrawal
    Indian Journal of Endocrinology and Metabolism.2021; 25(6): 493.     CrossRef
  • Predictors of dopamine agonist resistance in prolactinoma patients
    Elle Vermeulen, Jean D’Haens, Tadeusz Stadnik, David Unuane, Kurt Barbe, Vera Van Velthoven, Sven Gläsker
    BMC Endocrine Disorders.2020;[Epub]     CrossRef
  • The Role of Dopamine Agonists in Pituitary Adenomas
    Erica A. Giraldi, Adriana G. Ioachimescu
    Endocrinology and Metabolism Clinics of North America.2020; 49(3): 453.     CrossRef
  • Prevalence of Thyroid Disease in Patients Surgically Treated for Pituitary Disease
    Kim, Cho, Ku, Jung, Moon, Kim, Shin, Kim, Lee
    Journal of Clinical Medicine.2019; 8(8): 1142.     CrossRef
  • Articles in 'Endocrinology and Metabolism' in 2014
    Won-Young Lee
    Endocrinology and Metabolism.2015; 30(1): 47.     CrossRef
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