Nonfunctioning Pituitary Tumors
Patients with a pituitary gland lesion seen on MRI, but without a hormone excess syndrome may have a Non-functioning (or non-secreting) pituitary tumor and may be eligible to participate in a “Prospective Study of Clinically Non-functioning Pituitary Adenomas”. The study is conducted by Pituitary Center faculty Pamela U. Freda MD (Principal Investigator), Sharon L. Wardlaw MD (Co-Investigator), Jeffrey N. Bruce (Co-Investigator), Steven Isaacson MD and Yaakov Stern, PhD . This study, funded by R01 NS070600 from NINDS/NCI and is registered at Clinical Trials.gov by identifier: NCT01556230. The study will follow two groups of patients with pituitary lesions, one group that does not require surgical intervention and another group whose tumor requires surgery. After the initial visit the follow up visits are conducted in 6 months, 1 year and yearly thereafter. Visits include an interview and physical examination by Dr. Freda, laboratory testing, quality of life questionnaires and neurocognitive (memory) testing. Attached is the study brochure. (Attach IRB approved brochure). Interested patients may contact the Principal Investigator Dr. Pamela Freda at 212-305-2254 or the study coordinator Amanda Wade, MPH, CRCC at 212-305-7243
Patients with suspected or known acromegaly, either newly diagnosed or after treatment may be eligible to participate in research studies that examine “New approaches to the Evaluation and Treament of Acromegaly”. These studies, funded by NIH grants R01DK064720 and K24 DK073040 from the NIH, NIDDK are conducted by Pamela U. Freda MD (Principal Investigator) and Jeffrey N. Bruce MD (clinical trials.gov identifier…). Patients may participate in aProspective Acromegaly Study: Newly diagnosed or previously treated for acromegaly will have visits and blood testing for evaluation of GH and IGF-I levels and assessment of cure and cardiovascular risk over time after and during therapy. (Click here for IRB approved AAAA0890 study brochure). Patients may also participate in a studies that assesses body composition in patients with acromegaly. Patients will have measurements of total body fat, muscle and bone mineral by MRI and/or DEXA and metabolic rate before and after treatment. Patients may also participate in a fat biopsy study which assesses inflammation in fat over time before and after treatment. (CUMC IRB approved protocol numbers:..). Patients may also participate in studies which examine the outcome of medical therapy for acromegaly.
Interested patients may contact the Principal Investigator Dr. Pamela Freda at 212-305-2254 or the study coordinators Carlos Reyes-Vidal MD or Jean Carlos Fernandez MD at 212-305-4921.
Please click below for a brochure entitled Prospective Study of Pituitary Adenomas.
Ropinirole for the Treatment of Elevated Prolactin Levels
Elevated prolactin levels are commonly caused by pituitary tumors that produce prolactin (prolactinomas). These tumors are primarily treated with medications instead of surgery. Both bromocriptine and cabergoline lower prolactin levels and promote tumor shrinkage. However, these medications can have side effects and their prolonged use may be associated with heart valve disease.
Ropinirole is a medication that is FDA approved for use in patients with Parkinson’s disease and Restless Leg Syndrome that has been show to lower prolactin levels in patients with Parkinson’s disease and in healthy volunteers with few side effects.
The purpose of these studies is to determine if ropinirole can be used to effectively lower prolactin levels without significant side effects in patients with elevated prolactin levels. Study 1 evaluates how ropinirole affects prolactin levels over 24hrs. Study 2 examines the long-term effectiveness of ropinirole for treating high prolactin levels.
Please click below for a brochure entitled Ropinole for the Treatment of High Prolactin Levels
New Tests for the Diagnosis and Evaluation of Cushing’s Syndrome: Measuring POMC and AgRP
Patients who have the disorder known as ACTH-dependent Cushing’s syndrome, have inappropriately high levels of a hormone called ACTH in their blood,. This extra ACTH is being made either by a tumor in the pituitary (a gland in the brain) or by a tumor somewhere else in the body (ectopic tumor). Figuring out whether the ACTH is being made by a pituitary tumor or by an ectopic tumor can sometimes be quite difficult because brain MRI’s only identify ACTH-secreting pituitary tumors 50% of the time and the currently available non-invasive tests used to figure out where the ACTH is coming from, have limitations. While the test known as inferior petrosal sinus sampling is the best test for making a diagnosis, it is an invasive test that is not widely available. There is data to suggest that the patients with ACTH-secreting pituitary and ectopic tumors may differ in their ability to turn a protein called POMC into ACTH and in their ability to make a protein called AgRP.
The purpose of this study is to figure out if measuring the proteins, POMC and AgRP, in the blood in patients with ACTH-dependent Cushing’s can help physicians figure out if the tumor causing Cushing’s is a pituitary tumor or an ectopic tumor. The study is also designed to see if these proteins can be used as tumor markers, to monitor for tumor recurrence in patients after surgery.
ACTH is made from the protein POMC. There is data to suggest that ACTH-secreting
pituitary and ectopic tumors may differ in the their ability to convert POMC into
ACTH. Pituitary tumors appear to be good at breaking down POMC into ACTH, while
ectopic tumors do not seem to do as good of a job converting POMC into ACTH.
Additionally, we have found that some ectopic tumors are able to make AgRP, while
pituitary tumors do not appear to do so. Subsequently, we hypothesize that patients
with ectopic tumors will higher levels of POMC and/or AgRP in their blood than
patients with pituitary tumors, and this may help with diagnosis.