Abstract
Pituitary neuroendocrine tumors (PitNET) do not only belong to the most common intracranial neoplasms but seem to be generally more common than has been thought. Minimally invasive liquid biopsies have the potential to improve their early screening efficiency as well as monitor prognosis by facilitating the diagnostic procedures. This review aims to assess the potential of using liquid biopsies of different kinds of biomarker species that have only been obtained from solid pituitary tissues so far. Numerous molecules have been associated with the development of a PitNET, suggesting that it often develops from the cumulative effects of many smaller genetic or epigenetic changes. These minor changes eventually pile up to switch critical molecules into tumor-promoting states, which may be the key regulatory nodes representing the most potent marker substances for a diagnostic test. Drugs targeting these nodes may be superior for the therapeutic outcome and therefore the identification of such pituitary-specific cellular key nodes will help to accelerate their application in medicine. The ongoing genetic degeneration in pituitary adenomas suggests that repeated tumor profiling via liquid biopsies will be necessary for personalized and effective treatment solutions.
Highlights
In recent years, reports of a high prevalence of adenomas in the pituitary gland have become more widespread in the literature, which gives rise to the impression that they may be more common than previously considered [1,2]
This review aims to assess the potential of looking for these different kinds of biomarker species in liquid biopsies since they have only been obtained from solid pituitary tissues so far
The presented studies show that DNA holds many information that could be beneficial for the diagnostics of pituitary neuroendocrine tumor (PitNET), no studies have been conducted yet that tried to confirm these findings in ctDNA
Summary
Reports of a high prevalence of adenomas in the pituitary gland have become more widespread in the literature, which gives rise to the impression that they may be more common than previously considered [1,2]. Many of the markers investigated so far are linked to these four mechanisms and correlations with invasive PitNET have been shown in several studies [11,12,13,14,15,16] Misregulations of these molecules are not specific to the pituitary as they exist in other tumor types as well. Resulting epigenetic modifications may in turn change the expression of many types of non-coding RNAs or proteins directly, which can be just as momentous for the cell as a driver mutation Finding such changes that reflect the properties and/or progression of a pituitary tumor is the most important aspect in search of a good biomarker. This review aims to assess the potential of looking for these different kinds of biomarker species in liquid biopsies since they have only been obtained from solid pituitary tissues so far
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