Bromocriptine is an effective treatment for most
prolactinomas.
Estrogen receptor (ER) antagonists are an alternative for treating patients with
bromocriptine-resistant
prolactinomas (BCRP). Previously, we reported that
fulvestrant, a selective ER antagonist, significantly inhibited the proliferation of, and
prolactin secretion by, MMQ cells, a
prolactin-secreting rat pituitary cell line, an exemplary model for
prolactinoma. In this study, we used
fulvestrant to block ERα expression by MMQ cells and analyzed the expression of β-
catenin and Wnt inhibitory factor-1 (WIF1) to investigate the effects of
fulvestrant on the Wnt signaling pathway. In addition, we examined the gene expression of ERα, β-
catenin and WIF1 in clinical BCRP specimens to explore the correlation between gender and clinical features. There was no significant difference in β-
catenin expression between
fulvestrant-treated cells and untreated cells, whereas WIF1 expression was higher in the treated cells. In clinical BCRP specimens, ERα expression was higher (especially in male patients), whereas β-
catenin expression was similar to normal pituitaries. In addition, WIF1 expression was significantly lower in BCRP specimens than in normal pituitaries. The
tumor volume was larger in male patients than in female patients.
Prolactin concentration was positively correlated with
tumor volume, and a positive linear correlation was observed between ERα expression and
tumor volume. In conclusion, the anti-
tumor activity of
fulvestrant on MMQ cells seems to be associated with ERα and the non-canonical Wnt pathway, and higher ERα levels in male patients with BCRP may contribute to the larger
tumor volumes observed.
Fulvestrant holds promise as a therapeutic agent for BCRP.