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Published in: Pituitary 1/2017

01-02-2017

Somatostatin receptor ligands in acromegaly: clinical response and factors predicting resistance

Authors: Rosa Maria Paragliola, Salvatore Maria Corsello, Roberto Salvatori

Published in: Pituitary | Issue 1/2017

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Abstract

Introduction

Somatostatin (SST) receptor ligands (SRL), in particular those of first generation (Octreotide and Lanreotide), are widely used in medical treatment of acromegaly, but they assure biochemical control of disease (and the possibility of an improvement of clinical symptoms and tumor shrinkage), only in a subset of patients.

Discussion

The mechanisms underlying the so called “SRL resistance” are various and involve in particular SST receptor expression and molecular pathways of signal transduction. Different predictors of SRL response have been reported, including clinical and biochemical features (gender, age, growth hormone and insulin-like growth factor-I levels at diagnosis), and tumor characteristic (both at preoperative magnetic resonance imaging study and histopathology) as well as expression of SST receptors. In some cases, only a “partial resistance” to SST can be detected, probably due to the presence of other impaired molecular mechanisms involved in signal transduction, which compromise specific pathways and not others. This may explain some cases of dissociated response between biochemical control and tumor shrinkage.
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Metadata
Title
Somatostatin receptor ligands in acromegaly: clinical response and factors predicting resistance
Authors
Rosa Maria Paragliola
Salvatore Maria Corsello
Roberto Salvatori
Publication date
01-02-2017
Publisher
Springer US
Published in
Pituitary / Issue 1/2017
Print ISSN: 1386-341X
Electronic ISSN: 1573-7403
DOI
https://doi.org/10.1007/s11102-016-0768-4

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