Resistance to Medical Therapy in Pituitary Tumors

In the era of personalized target therapies, patients with pituitary tumors may display resistance to conventional medical treatments, including somatostatin analogs (SA) and dopamine agonists (DA). Resistance to medical treatment generally leads to multi-modal therapy including surgery and radiotherapy, but tumors frequently relapse after radical surgical excision. Such a phenomenon is of crucial interest, as it occurs in up to two thirds of patients with pituitary tumors and is nowadays considered predictive of aggressive behavior of the tumor, therefore associated with poor prognosis and increased mortality. Predictors of responsiveness to medical treatments are still under investigation, and no clear clinical factor has been identified to drive endocrinologists through the choice of the best individualized medical therapy in patients with pituitary malignancies.

This Research Topic will focus on resistance in medical therapy in pituitary tumors, and will address molecular and genetic mechanisms hypothesized to explain the resistance to SA and DA treatment, and consequent clinical implications. We welcome reviews and original research focusing on the following:

• The expression of somatostatin and dopamine receptors in normal and tumoral pituitary, molecular, and genetic mechanisms of resistance, and clinical consequences,
• Future therapeutic perspectives for patients.