Our group has focused on the exome sequencing of growth hormone secreting adenomas as a discovery set. Using a validation cohort of 300 adenomas from all secretory groups, we were able to screen tumors for variants across all chromosomal regions. The copy number alterations (CNAs) found across tumor types correlates well with clinical aggressiveness and medical resistance. This is most striking for aggressive and dopamine resistant prolactinomas, which show gains and losses on nearly every chromosome. This investment will allow our group to perform exome sequencing on a well-defined and clinically characterized discovery cohort of medically resistant prolactinomas. We also have a larger cohort of nearly 150 additional prolactinomas, as a validation cohort (and a complete cohort of 400 tumors from all groups). These additional data will form the basis of a high impact publication on the genomic landscape of pituitary adenomas and the foundation for a NIH grant submission.