Medical therapies for ACTH-producing tumors: What's the verdict?

In this article, the authors look at possible medical therapies to treat ACTH-producing tumors including those which cause Cushing's Disease (CD) and silent corticotroph adenoma (SCA). CD is caused by an ACTH producing pititary adenoma. SCA shows the same immunoreactivity of a pituitary adenoma without the same signs or symptoms of Cushing's. The authors take great pains to discuss and define the pathology of each of these.

This study examined the effect of somatostatin receptor (SSTR) subtype (1-5) and dopamine receptor type 2 (D2R) on CD, SCA, and non-functioning pituitary tumors (NFT). It is a meaty report with fairly detailed data for those who are interested and admits some limitations with differnt gene profiles of various pituitary tumors.

The advance publication text is free. In short, the authors concluded:

...the increased expression of SSTR5 in ACTH-secreting pituitary tumors causing overt CD and increased expression of SSTR1 and 2 in SCA...suggest that
somatostatin analogs more selective for SSTR5 and SSTR1 and/or 2 could be used
as an effective drug for medical treatment for CD and SCA, respectively, whereas
the clinical application of dopamine agonists selective for DR2 is very limited
in CD or SCA.

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Toru TATENO, Masako KATO, Yuji TANI, Kenichi OYAMA, Shozo YAMADA and Yukio HIRATA (2009). Differential Expression of Somatostatin and Dopamine Receptor Subtype Genes in Adrenocorticotropin (ACTH)-Secreting Pituitary Tumors and Silent Corticotroph Adenomas Endocrine JournalDOI: 10.1507/endocrj.K08E-186