Xiii Annual Meeting On Pituitary Tumors Uptodate On Pitnet From Basic Research To Clinical Management

Pituitary adenomas/PitNET represents a complex disease, with a wide spectrum of clinical manifestations, from small benign lesions to aggressive PitNET, according to the ability of secreting different hormones or pro-hormones or of invading the neighbouring anatomical structures and to treatment resistance. Macroadenomas can cause mass effect, consisting of visual field defects, headache or hypopituitarism. People with hypopituitarism due to pituitary adenomas have an approximately 2-fold increase in all-cause mortality compared with the general population. Some syndromes of pituitary hormone excess are also associated with excess all-cause mortality. Acromegaly was associated with a 2-fold increase in all-cause mortality rate in studies published before 2008, but not in more recently published studies or in the subgroups of patients who achieved biochemical control of the disease. Cushing disease has been associated with a 3-fold increase in all-cause mortality rate. Aggressive PitNETs (APTs) are a small subset, around 10% of all PitNETs, defined as tumours which are radiologically invasive with unusually rapid tumour growth or clinically relevant tumour growth despite optimal standard therapies. Pituitary carcinomas (PCs) specifically denote APTs that have metastasised (craniospinal or systemic) and comprise up to 0.4% of all PitNETs. Current guidelines for the management of APTs and PCs recommend treatment with surgery, radiotherapy and temozolomide; however by definition these tumours progress despite these therapies and treatment options beyond current recommendations are experimental. In this field, precision medicine management is a rapidly expanding area that enables delivery of molecular based personalised therapies, and this approach may improve outcomes for patients with PitNET. In the recent years, a wide number of research investigated the genetic, molecular and biological features of PitNETs, in order to predict the clinical behaviour of these neoplasia and to personalize the treatments.

The current event has the aim of updating participants on the latest biological, genetic and clinical acquisitions on PitNET and on their impact in the management of PitNET affected patients according to the new knowledge, that requires a close clinical collaboration between neuroendocrinologist, ophthalmologist, pathologists, neurosurgeons, radiotherapist and nuclear medicine physician.

The meeting is part of the teaching activities of the Master Degree in Diagnosis and Treatment of pituitary disease - Faculty of Medicine, Universita' Cattolica del Sacro Cuore, Rome.