Acromegaly can be cured by first-line pasireotide treatment?

Chiloiro, Sabrina; Giampietro, Antonella; Bianchi, Antonio; Tartaglione, Tommaso; Bima, Chiara; Vita, Maria Gabriella; Spinello, Maurizio; Pontecorvi, Alfredo; Marinis, Laura De

doi:10.1007/s12020-019-01874-4

Cited by 7 publications

(5 citation statements)

References 11 publications

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“…To the best of our knowledge, there is only one case report on the persistent remission after the discontinuation of pasireotide long-acting release (PAS-LAR) in acromegaly. 14 Here, we reported complete remission after the 21-month withdrawal of PAS-LAR in a patient with acromegaly cured by the administration of PAS-LAR.…”

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confidence: 65%

“…The long‐term hormonal remission rate in patients with acromegaly after the discontinuation of first‐generation SSAs has been explored in several studies, 6‐13 whereas that after the withdrawal of pasireotide has not been included. To the best of our knowledge, there is only one case report on the persistent remission after the discontinuation of pasireotide long‐acting release (PAS‐LAR) in acromegaly 14 . Here, we reported complete remission after the 21‐month withdrawal of PAS‐LAR in a patient with acromegaly cured by the administration of PAS‐LAR.…”

Section: Introductionmentioning

confidence: 78%

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Persistent remission of acromegaly in a patient with GH‐secreting pituitary adenoma: Effect of treatment with pasireotide long‐acting release and consequence of treatment withdrawal

Wang

Yang

et al. 2022

Clinical Pharmacy Therapeu

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What is known and objective Somatostatin analogues (SSAs) have been used for the treatment of acromegaly for several decades. However, a unified conclusion on the duration of SSAs therapy or the possibility of medication withdrawal is still missing. We aimed to report a case of acromegaly cured by pasireotide long‐acting release (PAS‐LAR) and provide some information on the withdrawal of SSAs after stable regression in acromegalic patients. Case summary A 55‐year‐old male patient, who was diagnosed with acromegaly and refused surgery and received PAS‐LAR as initial treatment, had maintained stability for ten years under the regular treatment with PAS‐LAR. The pituitary microadenoma was also decreased during the treatment. After the PAS‐LAR discontinuation for 21 months, no evidence of biochemical or clinical recurrence was found in this patient. What is new and conclusion The use of PAS‐LAR in a subset of naive‐treatment patients is promising to induce long‐term regression. A subgroup of patients with mild and well‐controlled acromegaly might hope for perpetual remission after the withdrawal of medication.

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confidence: 65%

Section: Introductionmentioning

confidence: 78%

Persistent remission of acromegaly in a patient with GH‐secreting pituitary adenoma: Effect of treatment with pasireotide long‐acting release and consequence of treatment withdrawal

Wang

Yang

et al. 2022

Clinical Pharmacy Therapeu

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“…In their case report, they noted that hormonal control was accompanied by tumour shrinkage during pasireotide therapy, and that when the drug was withdrawn, acromegaly did not recur after 21 months of follow‐up. This study adds to a small but growing body of work showing dramatic long‐term responses of pituitary adenomas to pasireotide 2‐6 . Previously, in 2019, we reported our experience in two acromegaly patients with germline AIP mutations whose disease was resistant to surgery and had poor responses to first‐generation somatostatin analogues 7 .…”

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confidence: 76%

“…This study adds to a small but growing body of work showing dramatic long-term responses of pituitary adenomas to pasireotide. [2][3][4][5][6] Previously, in 2019, we reported our experience in two acromegaly patients with germline AIP mutations whose disease was resistant to surgery and had poor responses to first-generation somatostatin analogues. 7 Both patients achieved biochemical control of growth hormone (GH) and insulin-like growth factor-1 (IGF-1) and had marked tumour shrinkage.…”

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confidence: 99%

Comment on "Persistent remission of acromegaly in a patient with GH‐secreting pituitary adenoma: Effect of treatment with pasireotide long‐acting release and consequence of treatment withdrawal"

Daly

2022

Clinical Pharmacy Therapeu

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“…Recently, the immunostaining of tumoral somatotroph cells became important because therapy response to SSTAs is modulated by SSTRs expression and it might predict the type of response thus it indicates which SSTA should be used [2,35,40,41] (Figure 7, A and B). As mentioned, the focus in on SSTR2 and SSTR5: if a somatotropinoma has mostly type 2 is more likely that acromegaly will be controlled with first line medical SSTAs molecules, while in tumors with type 5 preponderance, the subjects become candidates to Pasireotide in active disease under first generation SSTAs [42][43][44]. Pasireotide is a multi-targeted analogue, meaning that it binds mainly SSTR5 but also SSTR1, SSTR2, and SSTR3 [23].…”

Section: Figure 6 -Histological Report In a Case Of Ghproducing Pituimentioning

confidence: 99%

Somatostatin receptors in normal and acromegalic somatotroph cells: the U-turn of the clinician to immunohistochemistry report – a review

Ionovici

Cârșote

Terzea

et al. 2020

Rom J Morphol Embryol

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This is a narrative review of literature introducing somatostatin receptors (SSTRs) as part of understanding the somatotroph cells since they are positive in normal cells but also in tumoral cells as seen in somatotropinoma, a growth hormone (GH)-producing neoplasia, which causes acromegaly. They are five subtypes of SSTRs (1 to 5), which are immunohistochemically positive in different proportions in somatotropinomas. SSTR types 2 and 5 are most frequent in GH-secreting adenomas and they are both targeted by medical therapy with somatostatin analogues (SSTAs) like first generation Octreotide and Lanreotide (mainly targeting SSTR2) and second generation Pasireotide (with highest affinity for SSTR5), thus heterogeneous SSTRs configuration into the tumor explains different pattern of response to treatment and it might predict it once the SSTRs immunostaining is performed. Monoclonal antibodies are used for immunohistochemical detection of SSTRs; currently, a lack of standardization is presented, and scoring systems, such as Volante, H-score or human epidermal growth factor receptor 2 (HER2)score, are applied. Immunoreactive markers like SSTRs are the U-turn in clinical practice regarding somatotropinomas since the configuration of subtypes 2 and 5 explains the responsiveness to medical therapy like SSTA. Further achievement of disease control is imperiously necessary because acromegaly has an increased rate of morbidity and mortality.

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Acromegaly can be cured by first-line pasireotide treatment?

Cited by 7 publications

References 11 publications

Persistent remission of acromegaly in a patient with GH‐secreting pituitary adenoma: Effect of treatment with pasireotide long‐acting release and consequence of treatment withdrawal

Persistent remission of acromegaly in a patient with GH‐secreting pituitary adenoma: Effect of treatment with pasireotide long‐acting release and consequence of treatment withdrawal

Comment on "Persistent remission of acromegaly in a patient with GH‐secreting pituitary adenoma: Effect of treatment with pasireotide long‐acting release and consequence of treatment withdrawal"

Somatostatin receptors in normal and acromegalic somatotroph cells: the U-turn of the clinician to immunohistochemistry report – a review

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