Cabergoline in Nonfunctioning Pituitary Adenomas
Cabergoline in Nonfunctioning Pituitary Adenomas
Clinically nonfunctioning pituitary adenoma remains the only pituitary tumor subtype for
 which no effective medical therapy is available or recommended. We will evaluate the use of
 cabergoline in a clinical trial, in order to define the efficacy of this treatment in
 nonfunctioning pituitary adenoma.
Nonfunctioning pituitary adenomas (NFPA) are common tumors of sellar region characterized by
 the absence of clinically hormonal pituitary secretion. These adenomas are typically not
 diagnosed until they become very large and cause compressive neurologic symptons (e.g. visual
 impairment or cranial nerve palsy). Most of them are able to synthesized gonadotropins but
 not secreted it.

 Transsphenoidal surgical resection is the first-choice therapy in NFPA. However, complete
 removal is difficult and tumor rest is very common. In these cases, the pragmatic use of
 radiotherapy is effective to reduce residual tumor growth or recurrence, but it is related
 with severe side effects. Another possibility is the clinical observation, or wait-to-see
 approach, but it is associated with tumor progression: 40% in 5-10 years. The efficacy of
 some medical treatment are not defined yet.

 Since the identification of dopaminergic and somatostatinergic receptors in NFPA, the
 pharmacological treatment of the NFPA has been considered as a possibility for treatment. To
 date, clinical use of dopamine agonist (DA) in NFPA patients has been evaluated in some
 studies. However, these studies present modest and inconclusive results and the DA role in
 the NPFA management remains undefined.

 In this study, the investigators plan a clinical trial designed to investigate the efficacy
 of cabergoline in NFPA individuals with remaining tumor after primary neurosurgery. These
 results could help to define the efficacy of DA in NFPA management.
Inclusion Criteria:

 -  presence of pituitary tumor rest at 6 months after neurosurgery

 -  absence of previous hormonal pituitary hypersecretion

 -  absence of previous radiotherapy and/or radiosurgery

 -  Histopathological exam showing pituitary adenoma

 Exclusion Criteria:

 -  ACTH immunoexpression at histopathological exam

 -  presence of previous radiotherapy and/or radio surgery

 -  psychotic psychiatric disease

 -  moderate or severe alterations in cardiac valves