Cabergoline for the treatment of bromocriptine-resistant invasive giant prolactinomas

Few studies have specifically focused on the effect of cabergoline on invasive giant prolactinomas (IGPs) resistant to bromocriptine. This study aims to evaluate whether cabergoline could be used as an effective therapy for patients with bromocriptine-resistant IGPs. This retrospective study included 15 patients with bromocriptine-resistant IGPs who received treatment at our department during 2007–2015. Cabergoline was administered in all 15 patients, with the dose adjusted depending on the prolactin response of each patient. Parameters for outcome assessment included prolactin level, pituitary function, tumor size, improvement of the clinical symptoms, visual field defects, drug tolerance, and disease recurrence. Cabergoline was effective for the treatment of the patients with bromocriptine -resistant IGPs as represented by normalization of the prolactin level in 12/15 patients; improvement or normalization of the pituitary function in 4/5 patients with hypopituitarism; significant reduction in tumor size in 14/15 patients; and relief of the clinical symptoms in 11/15 patients. All 15 patients showed good tolerance to cabergoline. In addition, no recurrence was observed during the mean follow-up period of 63.47 (range 30–145) months. Data of this retrospective study demonstrate that cabergoline is an excellent option for the treatment of patients with bromocriptine-resistant IGPs.