Precision Therapy in Acromegaly Caused by Pituitary Tumors: How Close Is It to Reality?

Abstract

Acromegaly presents with an enigmatic range of symptoms and comorbidities caused by chronic and progressive growth hormone elevations, commonly due to endocrinologic hypersecretion from a pituitary gland tumor. Comprehensive national acromegaly databases have been appearing over the years, allowing for international comparisons of data, although still presenting varying prevalence and incidence rates. Lack of large-scale analysis in geographical and ethnic differences in clinical presentation and management requires further research. Assessment of current and novel predictors of responsiveness to distinct therapy can lead to multilevel categorization of patients, allowing integration into new clinical guidelines and reduction of increased morbidity and mortality associated with acromegaly. This review compares current data from epidemiological studies and assesses the present-day application of prognostic factors in medical practice, the reality of precision therapy, as well as its future prospects in acromegaly, with a special focus on its relevance to the South Korean population.

Risk of Neurodegenerative Diseases in Patients With Acromegaly

“…Acromegaly is a rare disease characterized by excess growth hormone (GH) and insulin-like growth factor-1 (IGF-1), as well as enlarged bone, soft tissues, and organs. 1 Acromegaly progresses insidiously and slowly; therefore, the average interval from onset of symptoms to diagnosis ranges from 5 to 10 or more years. 2 Long-term exposure to excess GH and IGF-1 can cause multiple systemic complications and increased mortality in patients with acromegaly.…”

Predictors of morphofunctional features of somatotrophic tumors and of the effectiveness of treatment with first-generation somatostatin receptor ligands

“…Нейроэндокринные PIT1-позитивные ГР-продуцирующие опухоли гипофиза Other problems of endocrinology фенотипу. В связи с малой распространенностью биомаркеров, которые могли бы предсказать биологическое поведение опухоли и реакцию на лечение, практикуемая традиционная МТ вынуждена использовать метод проб и ошибок, который не отвечает современным принципам прецизионной и персонализированной терапии [13,14]. К сожалению, независимо от особенностей рецепторного фенотипа СО, всем нуждаю щимся в лечении пациентам в качестве препарата 1-й линии назначаются пролонгированные препараты АС1, эффективность которых в неселективной группе составляет около 40-50% [15].…”

Using a precision approach to optimize the drug therapy of patients with acromegaly syndrome

“…The Pituitary Gland -An Overview of Pathophysiology and Current Management Techniques humoral, imaging and pathomorphological predictors for preliminary stratification of clinically homogeneous patients with a clear clinical prognosis and response to treatment [16,17].…”

“…In a prospective study evaluating the effectiveness of lanreotide (120 mg every 28 days) as a first-line therapy, it was shown that the normalization of GH levels and IGF-I after 24 and 48 weeks of treatment were observed in 23.4 and 30.6% of patients. Thus, a significant part of patients receiving fg-SRLs has partial or complete resistance, which is a consequence of the internal heterogeneity of somatotropin in relation to the receptor expression of SSTs and other target molecules affecting the therapeutic response [16][17][18].…”