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Pituitary
Published in: Pituitary 2/2016

Open Access 01-04-2016

The effects of somatostatin analogue therapy on pituitary tumor volume in patients with acromegaly

Authors: Annamaria Colao, Renata S. Auriemma, Rosario Pivonello

Published in: Pituitary | Issue 2/2016

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Abstract

Introduction

In nearly all cases, acromegaly is caused by excess GH from a pituitary adenoma, resulting in elevated circulating levels of GH and, subsequently, IGF-1. Treatment goals are to eliminate morbidity and restore the increased mortality to normal rates. Therapeutic strategies aim to minimize tumor mass and normalize GH and IGF-1 levels. Somatostatin analogues are the medical treatment of choice in acromegaly, as first-line or post-surgical therapy, and have proven efficacy in pituitary tumor volume reduction (TVR).

Methods

Here we review the effects of somatostatin analogue therapy on pituitary tumor volume in patients with acromegaly.

Results

TVR with somatostatin analogues may be mediated by direct anti-proliferative effects via activation of somatostatin receptors, or by indirect effects, such as angiogenesis inhibition, and is more pronounced when they are administered as first-line therapy. Various studies of first-line treatment with octreotide LAR have shown significant TVR in ≥73 % of patients. First-line treatment with lanreotide Autogel has shown evidence of TVR, although more studies are needed. In a recent randomized, double-blind, 12-month trial in 358 medical-treatment-naïve acromegaly patients, significant TVR was achieved by 81 % of patients administered pasireotide LAR and 77 % administered octreotide LAR. Pre-operative somatostatin analogue therapy may also induce TVR and improve post-operative disease control compared with surgery alone. TVR is progressive with prolonged treatment, and decreased IGF-1 levels may be its best predictor, followed by age and degree of GH decrease. However, TVR does not always correlate with degree of biochemical control.

Conclusion

Somatostatin analogues (first- or second-line treatment) are the mainstay of medical therapy and, as first-line medical therapy, are associated with significant pituitary TVR in most patients.
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Metadata
Title
The effects of somatostatin analogue therapy on pituitary tumor volume in patients with acromegaly
Authors
Annamaria Colao
Renata S. Auriemma
Rosario Pivonello
Publication date
01-04-2016
Publisher
Springer US
Published in
Pituitary / Issue 2/2016
Print ISSN: 1386-341X
Electronic ISSN: 1573-7403
DOI
https://doi.org/10.1007/s11102-015-0677-y

Other articles of this Issue 2/2016

Pituitary 2/2016 Go to the issue

OriginalPaper

A prospective study of appetite and food craving in 30 patients with Cushing’s disease

OriginalPaper

A comparative analysis of ESM-1 and vascular endothelial cell marker (CD34/CD105) expression on pituitary adenoma invasion

OriginalPaper

Safety of long-term treatment with Pegvisomant: analysis of Spanish patients included in global ACROSTUDY

OriginalPaper

Temozolomide for aggressive ACTH pituitary tumors: failure of a second course of treatment

OBITUARY

Prof. Jens Sandahl Christiansen

OriginalPaper

Algorithm development and the clinical and economic burden of Cushing’s disease in a large US health plan database
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Developed by: Springer Medicine

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