Clinical applications of somatostatin analogs for growth hormone-secreting pituitary adenomas

Figures & data

Table 1 Main content of this review

Optimization of somatostatin analog treatment	Clinical predictor of medical treatment
	Preselection before medical treatment
	Achieve long-term stable blood concentration
	Clinical use in presurgical period and impact on surgery
	Comparison of lanreotide Autogela and octreotide long-acting release
Different strategies	Primary or secondary therapy
Drug combinations	Pegvisomant; cabergoline
New somatostatin analogs
Treatment of gigantism

Note:

a Ipsen, Paris, France.

Table 2 Definition of response to somatostatin analog treatment (12 months)

	Biochemical response	Tumor response
Full response	Random serum GH <2.5 ng/mL and a normal IGF-1 for age and sex	>20% tumor shrinkage in patients with primary treatment; stabilization of tumor remnant or no recurrence in patients treated with secondary treatment
Partial response	Significant decrease(>50%) of GH level and/or failure to control IGF-1 levels	With or without tumor shrinkage
Resistance	Nonsignificant decrease of GH and IGF-1 levels with no achievement of control	No tumor shrinkage in patients treated first-line or increase in tumor size in any patient

Notes: OGTT is not recommended for monitoring therapeutic response during SA treatment. Data from Melmed et al.¹⁴ Republished with modification in full response of Biochemical response and with permission of Endocrine Society, from Resistance to soma tostatin analogs in acromegaly. Colao A, Auriemma RS, Lombardi G, Pivonello R. 2011;32(2):247–271.³³ Permission conveyed through Copyright Clearance Center, Inc.

Abbreviations: GH, growth hormone; IGF-1, insulin-like growth factor 1; OGTT, oral glucose tolerance test.

Figure 1 Proposed treatment strategy for patients with acromegaly.

Abbreviations: GH, growth hormone; IGF-1, insulin-like growth factor 1; MRI, magnetic resonance imaging; SA, somatostatin analog.

MelmedSColaoABarkanAAcromegaly Consensus GroupGuidelines for acromegaly management: an updateJ Clin Endocrinol Metab20099451509151719208732

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ColaoAAuriemmaRSLombardiGPivonelloRResistance to soma-tostatin analogs in acromegalyEndocr Rev201132224727121123741

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