Regression of a nonfunctioning pituitary macroadenoma on the CDK4/6 inhibitor palbociclib: case report

Neurosurgical Focus
Emily AndersonCarl B Heilman

Abstract

A 71-year-old female patient was referred in 2013 for evaluation of an asymptomatic nonsecreting pituitary adenoma. The adenoma, measuring 13 mm in height by 10 mm in width, was discovered incidentally on imaging in 2012. Biochemical testing demonstrated a nonfunctioning adenoma. Given the relatively small lesion size and the lack of symptoms, observation was preferred over surgical intervention. The patient was monitored with routine MRI, which until 2016 demonstrated minimal growth. In early 2016, the patient developed recurrence of metastatic breast cancer and was treated with palbociclib, a cyclin-dependent kinase (CDK) 4/6 inhibitor. This inhibitor acts on a pathway believed to be involved in pituitary adenoma tumorigenesis. One year after starting palbociclib, routine imaging demonstrated significant regression of her pituitary adenoma. The authors hypothesize that inhibition of the CDK4/6 pathway by palbociclib contributed to adenoma regression in this patient, and that palbociclib may represent a possible adjuvant therapy for the treatment of nonfunctioning pituitary adenomas.

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Citations

Dec 14, 2018·Neurosurgical Focus·Seyed Amir Javadi, Mehdi Zeinalizadeh
Jun 19, 2019·British Journal of Neurosurgery·Hossein GhalaenoviArash Fattahi
Sep 16, 2020·The Journal of Clinical Endocrinology and Metabolism·Andrew L LinEliza B Geer
Mar 11, 2021·Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [and] German Diabetes Association·Stephan Petersenn
Sep 9, 2021·Nature Reviews. Endocrinology·Gérald RaverotThierry Brue

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