Vnitr Lek 2024, 70(1):13-16 | DOI: 10.36290/vnl.2024.002

Personalized treatment of acromegaly - prediction of therapeutic response

Filip Gabalec, Jan Drugda, Jan Čáp
IV. interní hematologická klinika, Fakultní nemocnice Hradec Králové a Univerzita Karlova, Lékařská fakulta v Hradci Králové

The article deals with the issue of personalized treatment of acromegaly with emphasis on prediction of therapeutic response. In the context of the rapidly developing field of personalized medicine, it emphasizes the variability of the clinical, biochemical and radiological features of acromegaly and the need for more accurate classification and personalized therapeutic approaches. Surgery remains the main therapeutic approach, and this article analyzes preoperative predictors of successful surgery, such as higher growth hormone concentrations before surgery and the negative impact of cavernous sinus invasion. Factors including signal intensity on MRI and SSTR2A and SSTR5 receptor expression are investigated during somatostatin analogue therapy. The importance of mathematical analyses and artificial intelligence models in predicting therapeutic response is also discussed. Currently, it is necessary to develop new algorithms for therapy selection in order to treat patients with acromegaly more effectively.

Keywords: personalized medicine, acromegaly, precision medicine, somatostatin analogues, neurosurgery.

Accepted: February 9, 2024; Published: February 26, 2024  Show citation

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Gabalec F, Drugda J, Čáp J. Personalized treatment of acromegaly - prediction of therapeutic response. Vnitr Lek. 2024;70(1):13-16. doi: 10.36290/vnl.2024.002.
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    References

    1. Endocrinology TLD&. Precision medicine: improving accuracy, reducing error. Lancet Diabetes Endocrinol. 1. listopad 2023;11(11):783. Go to original source... Go to PubMed...
    2. Asa SL, Kucharczyk W, Ezzat S. Pituitary acromegaly: not one disease. Endocr Relat Cancer. 2017;24(3):C1-4. Go to original source... Go to PubMed...
    3. Asa SL, Mete O, Perry A, Osamura RY. Overview of the 2022 WHO Classification of Pituitary Tumors. Endocr Pathol. 2022;33(1):6-26. Go to original source...
    4. 2021 WHO Classification of Tumors of the Central Nervous System: a summary | Neuro-Oncology | Oxford Academic [Internet]. [citován 23. leden 2024]. Available from https://academic.oup.com/neuro-oncology/article/23/8/1231/6311214
    5. Starnoni D, Daniel RT, Marino L, et al. Surgical treatment of acromegaly according to the 2010 remission criteria: systematic review and meta-analysis. Acta Neurochir (Wien). 2016;158(11):2109-21. Go to original source... Go to PubMed...
    6. Abu Dabrh AM, Mohammed K, Asi N, et al. Surgical Interventions and Medical Treatments in Treatment-Naïve Patients With Acromegaly: Systematic Review and Meta-Analysis. J Clin Endocrinol Metab. 2014;99(11):4003-14. Go to original source... Go to PubMed...
    7. Melmed S, Bronstein MD, Chanson P, et al. A Consensus Statement on acromegaly therapeutic outcomes. Nat Rev Endocrinol. 2018;14(9):552-61. Go to original source... Go to PubMed...
    8. Agrawal N, Ioachimescu AG. Prognostic factors of biochemical remission after transsphenoidal surgery for acromegaly: a structured review. Pituitary. 2020;23(5):582-94. Go to original source... Go to PubMed...
    9. Briceno V, Zaidi HA, Doucette JA, Onomichi KB, Alreshidi A, Mekary RA, et al. Efficacy of transsphenoidal surgery in achieving biochemical cure of growth hormone-secreting pituitary adenomas among patients with cavernous sinus invasion: a systematic review and meta-analysis. Neurol Res. 2017;39(5):387-98. Go to original source... Go to PubMed...
    10. Brue T, Rahabi H, Barry A, et al. Position statement on the diagnosis and management of acromegaly: the French National Diagnosis and Treatment Protocol (NDTP). Ann Endocrinol. 2023;S0003-4266(23)00686-8. Go to original source... Go to PubMed...
    11. Colao A, Auriemma RS, Pivonello R, et al. Interpreting biochemical control response rates with first-generation somatostatin analogues in acromegaly. Pituitary. 2016;19:235-47. Go to original source... Go to PubMed...
    12. Gadelha MR, Wildemberg LE, Bronstein MD, et al. Somatostatin receptor ligands in the treatment of acromegaly. Pituitary. 2017;20(1):100-8. Go to original source... Go to PubMed...
    13. Brzana J, Yedinak CG, Gultekin SH, Delashaw JB, Fleseriu M. Growth hormone granulation pattern and somatostatin receptor subtype 2A correlate with postoperative somatostatin receptor ligand response in acromegaly: a large single center experience. Pituitary. 2013;16(4):490-8. Go to original source... Go to PubMed...
    14. Potorac I, Petrossians P, Daly AF, et al. T2-weighted MRI signal predicts hormone and tumor responses to somatostatin analogs in acromegaly. Endocr Relat Cancer. 2016;23(11):871-81. Go to original source... Go to PubMed...
    15. Puig-Domingo M, Resmini E, Gomez-Anson B, et al. Magnetic Resonance Imaging as a Predictor of Response to Somatostatin Analogs in Acromegaly after Surgical Failure. J Clin Endocrinol Metab. 2010;95(11):4973-8. Go to original source... Go to PubMed...
    16. Nista F, Corica G, Castelletti L, et al. Clinical and Radiological Predictors of Biochemical Response to First-Line Treatment With Somatostatin Receptor Ligands in Acromegaly: A Real-Life Perspective. Front Endocrinol. 2021;12:677919. Go to original source... Go to PubMed...
    17. Fougner SL, Borota OC, Berg JP, et al. The clinical response to somatostatin analogues in acromegaly correlates to the somatostatin receptor subtype 2a protein expression of the adenoma. Clin Endocrinol (Oxf). 2008;68(3):458-65. Go to original source... Go to PubMed...
    18. Ozkaya HM, Comunoglu N, Sayitoglu M, et al. Germline mutations of aryl hydrocarbon receptor-interacting protein (AIP) gene and somatostatin receptor 1-5 and AIP immunostaining in patients with sporadic acromegaly with poor versus good response to somatostatin analogues. Pituitary. 2018;21(4):335-46. Go to original source... Go to PubMed...
    19. Gatto F, Feelders RA, Van Der Pas R, Kros JM, Waaijers M, Sprij-Mooij D, et al. Immunoreactivity Score Using an Anti-sst2A Receptor Monoclonal Antibody Strongly Predicts the Biochemical Response to Adjuvant Treatment with Somatostatin Analogs in Acromegaly. J Clin Endocrinol Metab. 2013;98(1):E66-71. Go to original source... Go to PubMed...
    20. Wildemberg LEA, Neto LV, Costa DF, et al. Low somatostatin receptor subtype 2, but not dopamine receptor subtype 2 expression predicts the lack of biochemical response of somatotropinomas to treatment with somatostatin analogs. J Endocrinol Invest [Internet]. leden 2013 [cited 10. 12. 2023];36(1). Available from https://doi.org/10.3275/8305 Go to original source... Go to PubMed...
    21. Muhammad A, Coopmans EC, Gatto F, et al. Pasireotide Responsiveness in Acromegaly Is Mainly Driven by Somatostatin Receptor Subtype 2 Expression. J Clin Endocrinol Metab. 2019;104(3):915-24. Go to original source... Go to PubMed...
    22. Iacovazzo D, Carlsen E, Lugli F, et al. Factors predicting pasireotide responsiveness in somatotroph pituitary adenomas resistant to first-generation somatostatin analogues: an immunohistochemical study. Eur J Endocrinol. 2016;174(2):241-50. Go to original source... Go to PubMed...
    23. Soukup J, Hornychova H, Manethova M, et al. Predictive and prognostic significance of tumour subtype, SSTR1-5 and e-cadherin expression in a well-defined cohort of patients with acromegaly. J Cell Mol Med. 2021;25(5):2484-92. Go to original source... Go to PubMed...
    24. Ilie MD, Tabarin A, Vasiljevic A, et al. Predictive Factors of Somatostatin Receptor Ligand Response in Acromegaly-A Prospective Study. J Clin Endocrinol Metab. 2022;107(11):2982-91. Go to original source... Go to PubMed...
    25. Puig-Domingo M, Gil J, Sampedro-Nuñez M, et al. Molecular profiling for acromegaly treatment: a validation study. Endocr Relat Cancer. 2020;27(6):375-89. Go to original source... Go to PubMed...
    26. Trouillas J, Sassolas G, Guigard MP, et al. Relationships between pathological diagnosis and clinical parameters in acromegaly. Metab - Clin Exp. 1996;45:53-6. Go to original source... Go to PubMed...
    27. Gil J, Marques-Pamies M, Sampedro M, et al. Data mining analyses for precision medicine in acromegaly: a proof of concept. Sci Rep. 28. květen 2022;12(1):8979. Go to original source... Go to PubMed...
    28. Wildemberg LE, da Silva Camacho AH, Miranda RL, et al. Machine Learning-based Prediction Model for Treatment of Acromegaly With First-generation Somatostatin Receptor Ligands. J Clin Endocrinol Metab. 1. červenec 2021;106(7):2047-56. Go to original source... Go to PubMed...
    29. Albano L, Losa M, Barzaghi LR, Niranjan A, Siddiqui Z, Flickinger JC, et al. Gamma Knife Radiosurgery for Pituitary Tumors: A Systematic Review and Meta-Analysis. Cancers. leden 2021;13(19):4998. Go to original source... Go to PubMed...
    30. Pollock BE, Jacob JT, Brown PD, Nippoldt TB. Radiosurgery of growth hormone-producing pituitary adenomas: factors associated with biochemical remission. J Neurosurg. 2007;106(5):833-8. Go to original source... Go to PubMed...
    31. Losa M, Gioia L, Picozzi P, Franzin A, Valle M, Giovanelli M, et al. The Role of Stereotactic Radiotherapy in Patients with Growth Hormone-Secreting Pituitary Adenoma. J Clin Endocrinol Metab. 2008;93(7):2546-52. Go to original source... Go to PubMed...

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