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Safety of growth hormone replacement in survivors of cancer and intracranial 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 M.K. Biller
  • , George Brabant
  • , Catherine S.Y. Choong
  • , Stefano Cianfarani
  • , Peter E. Clayton
  • , Regis Coutant
  • , Adriane A. Cardoso-Demartini
  • , Alberto Fernandez
  • Adda Grimberg, Kolbeinn Guðmundsson, Jaime Guevara-Aguirre, Ken K Y Ho, Reiko Horikawa, Andrea M. Isidori, Jens Otto Lunde Jørgensen, Peter Kamenicky, Niki Karavitaki*, John J. Kopchick, Maya Lodish, Xiaoping Luo, Ann I. McCormack, Lillian Meacham, Shlomo Melmed, Sogol Mostoufi Moab, Hermann L. Müller, Sebastian J.C.M.M. Neggers, Manoel H. Aguiar Oliveira, Keiichi Ozono, Patricia A. Pennisi, Vera Popovic, Sally Radovick, Lars Savendahl, Philippe Touraine, Hanneke M. van Santen, Gudmundur Johannsson
*Corresponding author for this work
  • Federal University of Parana
  • University of Pittsburgh
  • Albert Einstein College of Medicine of Yeshiva University
  • University Medical Center Schleswig-Holstein
  • University of Manchester
  • Stanford University School of Medicine
  • Université Paris Cité
  • St. Joseph's Hospital and Medical Center, Phoenix
  • University of Arizona College of Medicine – Phoenix
  • Sainte-Justine University Hospital Centre
  • New York Presbyterian Hospital
  • Ludwig Maximilian University of Munich
  • Massachusetts General Hospital
  • Child & Adolescent Health Service
  • University of Western Australia
  • University of Rome Tor Vergata
  • IRCCS Ospedale Pediatrico Bambino Gesù
  • Karolinska Institutet
  • University Hospital of Angers
  • Hospital Universitario de Mostoles
  • University of Pennsylvania
  • The Children's Hospital of Philadelphia
  • Landspitali University Hospital
  • St Vincent’s Hospital
  • National Center for Child Health and Development
  • Université di Roma La Sapienza
  • Aarhus University Hospital
  • Université Paris-Saclay
  • University of Birmingham
  • Birmingham Health Partners
  • University Hospitals Birmingham NHS Foundation Trust
  • Ohio University
  • UCSF
  • Tongji Hospital
  • Garvan Institute of Medical Research
  • University of New South Wales
  • Emory University
  • Cedars-Sinai Medical Center
  • University of Oldenburg
  • Erasmus MC
  • Universidade Federal de Sergipe
  • Osaka University
  • Hospital de Niños Dr. Ricardo Gutiérrez
  • University of Belgrade
  • Robert Wood Johnson Medical School
  • Karolinska Institutet
  • Sorbonne Université
  • University Medical Center Utrecht
  • University of Gothenburg
  • Sahlgrenska University Hospital

Research output: Contribution to journalArticlepeer-review

119 Scopus citations

Abstract

Growth hormone (GH) has been used for over 35 years, and its safety and efficacy has been studied extensively. Experimental studies showing the permissive role of GH/insulin-like growth factor 1 (IGF-I) in carcinogenesis have raised concerns regarding the safety of GH replacement in children and adults who have received treatment for cancer and those with intracranial and pituitary tumours. A consensus statement was produced to guide decision-making on GH replacement in children and adult survivors of cancer, in those treated for intracranial and pituitary tumours and in patients with increased cancer risk. With the support of the European Society of Endocrinology, the Growth Hormone Research Society convened a Workshop, where 55 international key opinion leaders representing 10 professional societies were invited to participate. This consensus statement utilized: (1) a critical review paper produced before the Workshop, (2) five plenary talks, (3) evidence-based comments from four breakout groups, and (4) discussions during report-back sessions. Current evidence reviewed from the proceedings from the Workshop does not support an association between GH replacement and primary tumour or cancer recurrence. The effect of GH replacement on secondary neoplasia risk is minor compared to host- and tumour treatment-related factors. There is no evidence for an association between GH replacement and increased mortality from cancer amongst GH-deficient childhood cancer survivors. Patients with pituitary tumour or craniopharyngioma remnants receiving GH replacement do not need to be treated or monitored differently than those not receiving GH. GH replacement might be considered in GH-deficient adult cancer survivors in remission after careful individual risk/benefit analysis. In children with cancer predisposition syndromes, GH treatment is generally contraindicated but may be considered cautiously in select patients.

Original languageEnglish
Pages (from-to)35-52
Number of pages18
JournalEuropean Journal of Endocrinology
Volume186
Issue number6
DOIs
StatePublished - Jun 2022

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

  1. SDG 3 - Good Health and Well-being
    SDG 3 Good Health and Well-being

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