Prospective Study of Clinically Non-functioning Pituitary Adenomas

临床无功能垂体腺瘤的前瞻性研究

• 批准号: 8629798
• 负责人: PAMELA U FREDA
• 金额: $ 34.17万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-03-01 至 2017-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8629798
• 关键词: Caring; Clinical; Clinical Data; Corticotropin; Data; Development; Disease; Endocrine; Endocrinology; Evaluation; Functional disorder; Future; Growth; Guidelines; Investigation; Knowledge; Lead; Lesion; Link; Molecular; Monitor; Neurocognitive; Neurologic Dysfunctions; Operative Surgical Procedures; Outcome; Outcome Study; Pathology; Patient Care; Patients; Pituitary Gland; Pituitary Gland Adenoma; Pituitary Neoplasms; Plasma; Prevalence; Prospective Studies; Qualifying; Quality of life; Recurrence; Recurrent tumor; Reporting; Research Personnel; Residual state; Resources; Risk; Risk Factors; Safety; Series; Specimen; Therapy Evaluation; Time; Tumor Bank; Tumor Markers; base; clinical care; clinical practice; clinically significant; cognitive neuroscience; cohort; follow-up; improved; molecular marker; neurosurgery; novel; prospective; tumor; tumor growth

PROJECT SUMMARY This project will conduct the first comprehensive prospective study of clinically non- functioning pituitary adenomas (CNFA). Current clinical practices for the evaluation, treatment and follow up of patients with these pituitary adenomas are based on retrospectively collected data, which have many shortcomings. As a result, significant gaps exist in our knowledge about how to optimize these practices. A major barrier to improving our approach to these patients has been the lack of prospectively collected evidence to support or change it. We will overcome this barrier and answer the important outstanding questions about CNFA care. Aim 1 of this project is to prospectively study asymptomatic pituitary lesions that do not require surgical intervention in order to determine the appropriate initial evaluation and follow up as well as the safety of their conservative, non-surgical management. Aim 2 of this project is to prospectively assess the outcome of symptomatic CNFAs treated with surgery, the initial treatment of choice. Recurrences after surgery are common, but cannot be reliably predicted so we will study potential risk factors for tumor re-growth in particular the "silent" corticotroph tumor type. We will also assess the safety of conservative follow up for patients with small tumor remnants after surgery and determine in which of these patients RT is needed by examining the risks vs. benefits of post-operatively RT for residual/recurrent tumors. Aim 3 of the project is to examine for the first time, prospectively, the impact of the disease and our therapies on quality of life and neurocognitive function in patients with CNFAs. Aim 4 of the project will be to establish a novel bank of pituitary tumor specimens from our cohort that will be linked to the extensive clinical data collected in our prospective study. This bank will serve as a valuable resource for future collaborative studies of tumor markers and their clinical significance. Our investigative team with expertise in Endocrinology, Neurosurgery, Cognitive Neuroscience and Pathology is well qualified and equipped to undertake this study. The large number of patients referred to the team make us well situated to conduct this study. The project is further strengthened by its establishment of a large and unique prospectively followed cohort of CNFA patients and by its creation of a bank of pituitary tumors that is linked to its clinical data. This project will provide novel data on the evaluation, treatment and management of patients with clinically non-functioning pituitary adenomas.

项目摘要 该项目将对临床非 - 功能性垂体腺瘤（CNFA）。当前的评估临床实践，治疗 这些垂体腺瘤患者的随访是基于回顾性收集的 数据，有许多缺点。结果，我们的知识存在很大的差距 如何优化这些实践。改善我们对这些患者方法的主要障碍 一直缺乏前瞻性收集的证据来支持或更改它。我们将克服这一点 障碍并回答有关CNFA护理的重要问题。目标1 是前瞻性研究不需要手术干预的无症状垂体病变 为了确定适当的初始评估并跟进以及其安全性 保守，非手术管理。该项目的目标2是前瞻性评估 通过手术治疗的有症状CNFA的结果，最初的选择治疗。 手术后的复发很常见，但不能可靠地预测，因此我们将研究 肿瘤重新生长的潜在危险因素尤其是“沉默”皮质营养肿瘤类型。我们将 还要评估对肿瘤残留少量残留患者的保守随访的安全性 手术并通过检查风险V。确定需要哪些患者RT。 术后RT对残留/复发性肿瘤的好处。该项目的目标3是检查 前瞻性地，疾病和我们的疗法对生活质量的影响和 CNFA患者的神经认知功能。该项目的目标4将是建立小说 我们同类群的垂体肿瘤标本将与广泛的临床相关 在我们的前瞻性研究中收集的数据。该银行将成为未来的宝贵资源 肿瘤标记及其临床意义的协作研究。 我们的调查团队具有内分泌学，神经外科，认知方面的专业知识 神经科学和病理学有资格且能够进行这项研究。大 转交给团队的患者人数使我们在进行这项研究方面非常适合进行这项研究。项目 通过建立大型和独特的前瞻性遵循的队列，进一步加强了 CNFA患者及其通过创建与临床有关的垂体肿瘤的创建 数据。该项目将提供有关评估，治疗和管理的新数据 患有临床上无功能垂体腺瘤的患者。

项目成果

Pituitary incidentaloma: an endocrine society clinical practice guideline.

• DOI: 10.1210/jc.2010-1048
• 发表时间: 2011-04
• 期刊: The Journal of clinical endocrinology and metabolism
• 作者: Freda PU;Beckers AM;Katznelson L;Molitch ME;Montori VM;Post KD;Vance ML;Endocrine Society
• 通讯作者: Endocrine Society

Temozolomide (Temodar®) and capecitabine (Xeloda®) treatment of an aggressive corticotroph pituitary tumor.

替莫唑胺 (Temodar®) 和卡培他滨 (Xeloda®) 治疗侵袭性促肾上腺皮质激素垂体瘤。

• DOI: 10.1007/s11102-009-0211-1
• 发表时间: 2011
• 期刊: Pituitary
• 影响因子: 3.8
• 作者: Thearle,MarieS;Freda,PamelaU;Bruce,JeffreyN;Isaacson,StevenR;Lee,Yoomi;Fine,RobertL
• 通讯作者: Fine,RobertL