Safety of growth hormone replacement in survivors of cancer and intra-cranial and pituitary tumours ? A consensus statement

MARGARET C. S. BOGUSZEWSKI; CESAR L. BOGUSZEWSKI; WASSIM CHEMAILILLY; LAURIE E. COHEN; JUDITH GEBAUER; CLAIRE HIGHAM; ANDREW R. HOFFMAN; MICHEL POLAK; KEVIN C.J. YUEN; NATHALIE ALOS; ZOLTAN ANTAL; MARTIN BIDLINGMAIER; BEVERLEY MK BILLER; GEORGE BRABANT; CATHERINE S.Y. CHOONG; STEFANO CIANFARANI; PETER E. CLAYTON; JAMIE GUEVARA-AQUIRRE; SHLOMO MELMED; JOHN J. KOPCHICK; PATRICIA A. PENNISI; VERA POPOVIC; SALLY RADOVICK; LARS SAVENDAHL; HANNEKE H. VAN SANTEN; GUDMUNDUR JOHANNSSON

EUROPEAN JOURNAL OF ENDOCRINOLOGY

BIOSCIENTIFICA LTD

Lugar: Bristol; Año: 2022

0804-4643

GH has been used for over 35 years and its safety and efficacy has been studied extensively. Experimental96 studies showing the permissive role of GH/IGF-I in carcinogenesis have raised concerns regarding the safety97 of GH replacement in children and adults who have received treatment for cancer, and those with intracranial98 and pituitary tumours.99 A consensus statement was produced to guide decision-making on GH replacement in children and adult100 survivors of cancer, in those treated for intracranial and pituitary tumours and in patients with increased cancer101 risk.102 With the support of the European Society of Endocrinology, the Growth Hormone Research Society convened103 a Workshop, where 55 international key opinion leaders representing ten professional societies were invited104 to participate. This consensus statement utilized: (1) a critical review paper produced before the Workshop,105 (2) five plenary talks, (3) evidence-based comments from four breakout groups, and (4) discussions during106 report-back sessions.107 Current evidence reviewed from the proceedings from the Workshop does not support an association108 between GH replacement and primary tumour or cancer recurrence. The effect of GH replacement on109 secondary neoplasia risk is minor compared to host and tumour treatment-related factors. There is no110 evidence for an association between GH replacement and increased mortality from cancer amongst GH111 deficient childhood cancer survivors. Patients with pituitary tumour or craniopharyngioma remnants112 receiving GH replacement do not need to be treated or monitored differently than those not receiving GH.113 GH replacement might be considered in GH-deficient adult cancer survivors in remission after careful114 individual risk/benefit analysis. In children with cancer predisposition syndromes, GH treatment is generally115 contraindicated, but may be considered cautiously in select patients.