Corticotroph pituitary neuroendocrine tumour (Cushing disease and silent corticotroph tumour): lines of therapy

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2 standard-of-care settings across 2 lines and 1 biomarker subgroup. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.

Line	All comers
Advanced, first line	1
Second line	1

Advanced, first line

Subgroup	Setting	Approach	Products and trials	Guideline	Evidence
All comers	Cushing disease, first line	Transsphenoidal selective adenomectomy.	Pituitary tumours (pituitary neuroendocrine tumours) and pituitary carcinoma		-

Second line

Subgroup	Setting	Approach	Products and trials	Guideline	Evidence
All comers	Persistent or recurrent	Repeat surgery, radiotherapy, osilodrostat or another cortisol-directed drug (mifepristone blocks the glucocorticoid receptor and is used for the cortisol excess rather than the tumour), pasireotide or cabergoline, or bilateral adrenalectomy; temozolomide for aggressive tumours.	OsilodrostatPasireotideCabergolineStereotactic radiosurgery (Gamma Knife, CyberKnife, linac SRS)TemozolomideMifepristone		89

Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.