Towards precision medicine for clinically non-functioning pituitary tumours

Objective Clinically non-functioning pituitary tumours (NFPT) are a heterogenous group of neoplasms with diverse outcomes. The purpose of this narrative review was to summarize available data on predictive factors, both in routine practice and research settings. Design A literature review was conducted for papers published in peer-reviewed journals, investigating clinical, radiological, pathological and genetic predictive factors in NFPT. Results Several clinical and radiological factors have been associated with NFPT recurrence and/or aggressiveness, including larger size and pre-/post-operative growth rates. Application of transcription factor immunohistochemistry has given rise to improved subtype identification, including 'higher-risk' subtypes, in routine clinical practice. Numerous other pathological and genetic biomarkers have demonstrated promise for prognostication in the research setting. Conclusion NFPT are a heterogenous group of tumours, characterized by diverse presentation, pathogenesis and outcomes. Ongoing refinements in understanding of tumour biology are likely to pave the way to improved integrative prognostication and precision medicine for NFPT.

Automated summary

Clinically non-functioning pituitary tumors (NFPT) are a diverse group with various outcomes. This narrative review summarizes data on predictive factors in routine practice and research settings. Clinical and radiological factors are associated with NFPT recurrence/aggressiveness, with transcription factor immunohistochemistry improving subtype identification and promising pathological/genetic biomarkers for prognostication.