Biological targets and therapeutic strategies in the treatment of non-functioning pituitary tumors: state-of-the-art

Non-functioning pituitary neuroendocrine tumors (NF-PitNETs) represent one of the most common and heterogenous sellar pathology, and are nowadays still orphan of an effective pharmacological therapy that could substitute surgery or support in case of persistency/recurrence. In fact, despite NF-PitNETs are generally benign tumors, they can be characterized by supra- or extra-sellar growth with invasion of the cavernous sinus and/or involvement of the optical chiasm. For these reasons, lots of studies tried to unveil the molecular mechanisms underlying resistance and tumoral cells growth, so as to identify new possible therapeutic targets and novel drugs that could improve NF-PitNETs treatment. This review aims to summarize the new biological targets and therapeutic strategies that have been proposed so far, trying to give rise to novel approaches and paving the way for personalized strategies for patients harboring NF-PitNETs. In addition, further studies related to the complex mechanisms involved in NF-PitNETs resistance to the available therapies could provide the basis for the development of both prognostic biomarkers useful for patients' management and novel targets for the pharmacological treatment of these tumors.