Effect of pharmacological treatments used in aggressive adenomas and pituitary Carcinomas: a systematic review

• Grant number: 21/14151-7
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Start date: February 01, 2022
• End date: January 31, 2024
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Vania dos Santos Nunes Nogueira
• Grantee: Ana Beatriz Ribeiro Cardoso
• Host Institution: Faculdade de Medicina (FMB). Universidade Estadual Paulista (UNESP). Campus de Botucatu. Botucatu , SP, Brazil
• Associated research grant(s): 24/03532-8 - Endocrine Society Annual Meeting - ENDO 2024, AR.EXT

Abstract

The treatment of patients with pituitary carcinomas as well as pituitary tumors classified as aggressive represents a major challenge to current medicine, given that this group of neoplasms is more severe in its development than the benign adenomas that mostly affect the gland. It is known that these neoplasms have a lower degree of satisfactory response after the usual treatments with the main chemotherapy and radiological and surgical strategies, with high rates of non-responsiveness and tumor recurrence. Thus, given a scenario in which the persistence and evolution of the neoplastic disease are common after a series of therapeutic attempts, it is necessary to expand the spectrum of available pharmacological therapies in order to seek advances in the care provided to these patients. Objectives: This study aims to evaluate the tumor control obtained by the treatment of anti-neoplastic therapies that are still little explored in the context of aggressive tumors and pituitary carcinomas or that have a relatively new application through a systematic review of primary studies. The research will address the following therapies: Temozolamide, VEGF Inhibitors, Peptide Receptor Radionuclide Therapy, Everolimus, Immune Checkpoint Inhibitors, EGFR Inhibitors. Methods: A systematic review will be conducted in accordance with the protocol of the Joanna Briggs Institute (JBI) of Methodology for Systematic Reviews of Effectiveness which will include studies carried out in patients with aggressive pituitary tumors or pituitary carcinomas who underwent treatment with at least one of the selected drugs. The main outcome assessed by the study will be the frequency of tumor response to treatment according to the RECIST (Response Evaluation Criteria in Solid Tumors) protocol classification. Search strategies developed will be adapted to the electronic databases Embase (Elsevier, 1980-2021), Medline (PubMed, 1966-2021), LILACS (Virtual Health Library, 1982-2021), and The Cochrane Central Register of Controlled Trials (CENTRAL - Cochrane). The study selection process, risk of bias assessment, and data extraction will be carried out in pairs and independently by two reviewers. The research results will be reported in the final systematic review and presented by flowchart following the requirements of the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA).(AU)