Markers of Aggressiveness in Pituitary Tumors: Update and Perspectives

According to the 2018 ESE Guidelines [1], this diagnosis should be considered in the case of radiologically invasive tumors with unusually rapid growth rates or in the case of clinically relevant tumor growth despite optimal standard therapies. [...]a deeper understanding of the pathophysiological mechanisms that underlie PitNET aggressiveness could provide relevant information to inform the clinical management of patients with these tumors; the identification of prognostic markers of aggressiveness could allow for a more accurate prediction of patients’ prognosis and for a better choice of the intensity of follow-up; even more importantly, the identification of reliable markers of response to therapies could be helpful in the optimization and tailoring of treatment choices. [...]only approximately 3.5% of all analyzed miRNAs differed between USP8mut and USP8wt tumors; moreover, less than 10% of the predicted target genes based on miRNA/mRNA correlation analysis showed significantly different expression between these two tumor types. [...]based on these data, the differences in miRNA levels, although present, do not appear to play a pivotal role in determining the diversity in gene expression which is observed between USP8mut and USP8wt corticotroph tumors. [...]increasing attention has been paid to the role of tumor angiogenesis and immune microenvironment, which, in recent years, have been shown to be associated with the aggressiveness of various type of tumors (including melanoma, non-small cell lung cancer, breast cancer, and kidney cancer).