This month the PNA Spotlight focuses on Dr. Daniel Prevedello, who is a member of the PNA Board of Directors. Dr. Prevedello is an Associate Professor and Director of the Minimally Invasive Cranial Surgery Program in the Department of Neurological Surgery at the Ohio State University in Columbus. He attended medical school at the Federal University of Parana, Brazil and did an internship there, and then did two more internships, at Wayne State University in Michigan and at Ospedale Policlinico de Bari in Puglia, Italy. He did his residency at Hospital Nossa Senhora Das Gracas, in Curitiba, PR, Brazil. And he completed fellowships at the University of Virginia and the University of Pittsburgh. He was kind enough to answer some questions from the PNA. His responses follow.
The PNA would like to honor the memory of Dr. Donald P. Becker, a longtime member of the PNA who passed away on May 1, 2020. Dr. Becker was a respected neurosurgeon at UCLA Medical Center. At UCLA, he served as a Professor and Chief of Neurosurgery from 1985 – 2001 and then Senior Associate Dean for Academic Affairs in the David Geffen School of Medicine (2001-2007). He graduated from Case Western Reserve University School of Medicine in 1968 and completed his neurosurgical residency at the University Hospitals of Cleveland. From 1972-1985 he was Professor and Chairman at the Medical College of Virginia.
He wrote many scholarly articles and served as President of the Neurosurgical Society of America, served on the Board of Directors of the American Board of Neurological Surgery and the Journal of Neurosurgery Editorial Board. He retired as Director of the UCLA Brain Tumor Program in 2007. He was an avid horseman and golfer. The PNA expresses our deepest condolences to Dr. Becker’s family, friends and colleagues.
An article co-written by PNA member Dr. Maria Fleseriu, an endocrinologist at Oregon Health Sciences University, makes recommendations on how to maintain and even improve patient outcomes despite the challenges posed by COVID-19.
Eur J Endocrinol. 2020 May 1. pii: EJE-20-0473. doi: 10.1530/EJE-20-0473. [Epub ahead of print]
Endocrinology in the time of COVID-19: Management of pituitary tumours.
Patients with pituitary tumours, ensuing hormonal abnormalities and mass effects are usually followed in multidisciplinary pituitary clinics and can represent a management challenge even during times of non-pandemic. The COVID-19 pandemic has put on hold routine medical care for hundreds of millions of patients around the globe, while many pituitary patients' evaluations cannot be delayed for too long. Furthermore, the majority of patients with pituitary tumours have co-morbidities potentially impacting the course and management of COVID-19 (e.g. hypopituitarism, diabetes mellitus, hypertension, obesity, cardiovascular disease). Here, we summarize some of the diagnostic and management dilemmas for these patients, and we provide guidance on safe and as effective as possible delivery of care in the COVID-19 era. We also attempt to address how pituitary services should be remodeled in the event of similar crises, while maintaining or even improving patient outcomes. Regular review of these recommendations and further adjustments are needed, depending on the evolution of the COVID-19 pandemic status. We consider that utilization of successful models of pituitary multidisciplinary care implemented during the COVID-19 pandemic should continue after the crisis is over by using the valuable and exceptional experience gained during these challenging times.
Individuals with tumors of the pituitary (adenomas and carcinomas) that grow in spite of treatment with radiation are eligible for our clinical trial investigating whether the two immunotherapies, nivolumab and ipilimumab, are able to shrink these tumors.
The two immunotherapies, nivolumab and ipilimumab, are intravenous drugs that have revolutionized the treatment of melanoma and several other malignancies. These drugs allow the immune system to recognize and attack tumor cells. Individuals with pituitary tumors that grow in spite of standard treatments (in particular radiation) have few treatment options. For that reason, we are performing this phase II trial evaluating the efficacy of this drug combination on eligible patients.
There are limited treatment options for pituitary adenomas outside of surgery, radiation and endocrine therapy. Recent data indicate that some pituitary adenomas can respond to chemotherapy, such as temozolomide (TMZ). Further, studies of other neuroendocrine tumors have shown that the addition of another chemotherapy agent, capecitabine (CAP), may allow better responses. This is an open label study to assess the efficacy of capecitabine (CAP) and temozolomide (TMZ) in recurrent pituitary adenomas. Patients are treated in 28-day cycles with both agents (up to six cycles) with MRI imaging completed after every two cycles, and they are followed closely for any potential side effects associated with treatment. This trial may be a good option for patients who cannot (or prefer not to) receive additional radiation therapy or surgery.
An article in newsnextbd.com tells the story of 24-year-old Jinnat Ali, who passed away on April 28th from complications related to his acromegaly. He stood 8.2 feet tall. Doctors said they could not perform surgery, as the tumor was too complex. Read more: https://newsnextbd.com/?p=8980
Knowledge is power and we believe keeping abreast of news on the research front is imperative. Each month in Highlights we feature a few of the top news stories, which you can read below. In addition, we update our website on a regular basis with the latest breaking news related to pituitary and hormonal disorders by gathering stories we think you'll be interested in from MD Linx, Medscape, MedPage Today, PubMed, Touch Endocrinology, News-Medical.net and WebMD.
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The Pituitary Patient Resource Guide Sixth Edition is now available! Be one of the first to have the most up-to-date information. The Pituitary Patient Resource Guide a one of a kind publication intended as an invaluable source of information not only for patients but also their families, physicians, and all health care providers. It contains information on symptoms, proper testing, how to get a diagnosis, and the treatment options that are available. It also includes Pituitary Network Association's patient resource listings for expert medical care.