Patients & Clinicians

About non-functioning pituitary adenoma (NFPA)

NFPA is a serious disease with significant morbidity.

The pituitary is an endocrine, or hormone-producing, gland that is located at the base of the brain. This gland – the master regulator of endocrine function – plays a critical role in the human body, taking signals from the brain to produce hormones that regulate various functions of the body, including the other endocrine glands that produce their own hormones. Tumors of the pituitary can be functioning or non-functioning. Non-functioning tumors arise from gonadotroph cells in the pituitary and account for 30% of all pituitary adenomas.

NFPAs are pituitary tumors that disrupt critical structures in the surrounding area of the brain due to mass effect. They may cause vision loss, compression of the carotid artery leading to stroke, cranial nerve palsies, intractable headaches or hormone deficiencies.

Impact of NFPA

Currently, there are no approved medical therapies to treat NFPAs and treatment is limited to trans-sphenoidal surgery (TSS), which is performed through the nose and sinus passage, to remove the tumor and/or radiation to halt tumor growth. These two treatment options come with serious and high-risk consequences and are often ineffective in the longer-term.

It is estimated that approximately 5,000 TSS are performed each year in the U.S. to treat patients with NFPA and at least 48% of patients have tumor remnants after surgery. Approximately 18% of patients undergo more than two surgeries. Also, at least ~33% of patients require additional treatment regardless of first line therapy. In addition to these interventions, patients often require a complex set of medications to manage the endocrine disruption and other symptoms caused by the tumors and side effects of TSS and radiation. Regardless of remnant status post TSS, recurrence of NFPA can occur throughout the patient’s lifespan, requiring life-long radiologic monitoring (magnetic resonance imaging/MRI).

Patients typically visit multiple specialists on the road to a diagnosis and require a multidisciplinary care team including endocrinologists, neurosurgeons and other patient and symptom-specific specialists after diagnosis and initial surgery.

References:

[1] Dekkers OM, et al. (2008) “Treatment & follow-up of clinically NFP macroadenomas.” J. Clin. Endocrinol. Metab.; 93: 3717-3726.

[2] NFPA Natural History Analysis; data on file.