RT Journal Article
T1 Pasireotide in the Personalized Treatment of Acromegaly.
A1 Puig-Domingo, Manel
A1 Bernabéu, Ignacio
A1 Picó, Antonio
A1 Biagetti, Betina
A1 Gil, Joan
A1 Alvarez-Escolá, Cristina
A1 Jordà, Mireia
A1 Marques-Pamies, Montserrat
A1 Soldevila, Berta
A1 Gálvez, María-Angeles
A1 Cámara, Rosa
A1 Aller, Javier
A1 Lamas, Cristina
A1 Marazuela, Mónica
K1 PitNETs
K1 endocrine tumors
K1 growth hormone
K1 personalized medicine
K1 resistance to medical treatment in acromegaly
K1 somatostatin analogues
K1 somatostatin receptor ligands
K1 somatotroph adenoma
AB The delay in controlling the disease in patients who do not respond to first-line treatment with first generation somatostatin receptor ligands (first-generation SRLs) can be quantified in years, as every modification in the medical therapy requires some months to be fully evaluated. Considering this, acromegaly treatment should benefit from personalized medicine therapeutic approach by using biomarkers identifying drug response. Pasireotide has been positioned mostly as a compound to be used in first-generation SRLs resistant patients and after surgical failure, but sufficient data are now available to indicate it is a first line therapy for patients with certain characteristics. Pasireotide has been proved to be useful in patients in which hyperintensity T2 MRI signal is shown and in those depicting low SST2 and high expression of SST5, low or mutated AIP condition and sparsely granulated immunohistochemical pattern. This combination of clinical and pathological characteristics is unique for certain patients and seems to cluster in the same cases, strongly suggesting an etiopathogenic link. Thus, in this paper we propose to include this clinico-pathologic phenotype in the therapeutic algorithm, which would allow us to use as first line medical treatment those compounds with the highest potential for achieving the fastest control of GH hypersecretion as well as a positive effect upon tumor shrinkage, therefore accelerating the implementation of precision medicine for acromegaly. Moreover, we suggest the development, validation and clinical use of a pasireotide acute test, able to identify patients responsive to pasireotide LAR as the acute octreotide test is able to do for SRLs.
SN 1664-2392
YR 2021
FD 2021-03-16
LK http://hdl.handle.net/10668/17441
UL http://hdl.handle.net/10668/17441
LA en
DS RISalud
RD Apr 7, 2025