Predictive Factors of Somatostatin Receptor Ligand Response in Acromegaly—A Prospective Study - Centre de recherche en cancérologie de Lyon (UMR INSERM 1052 ; CNRS 5286 ; Centre Léon Bérard) Accéder directement au contenu
Article Dans Une Revue Journal of Clinical Endocrinology and Metabolism Année : 2022

Predictive Factors of Somatostatin Receptor Ligand Response in Acromegaly—A Prospective Study

Antoine Tabarin
Jean-François Bonneville
Lucile Moreau-Grangé
  • Fonction : Auteur
Franck Schillo
Brigitte Delemer
Dominique Figarella-Branger
Ségolène Bisot-Locard
Alexandre Santos

Résumé

Abstract Context Somatostatin receptor ligands (SRLs) are the cornerstone medical treatments for acromegaly; however, many patients remain unresponsive to SRLs. Well-established predictive markers of response are needed. Objective We aimed to explore the relationship between responsiveness to SRLs relative to somatostatin (SST)2A and 5 receptor expression, adenoma granularity, and T2-weighted magnetic resonance imaging (MRI) signal intensity (T2WSI). Methods We conducted a multicentric, prospective, observational cohort study, in France. Forty-nine naïve patients (ie, patients without preoperative SRL treatment) with active acromegaly following surgery were treated with octreotide (group 1; n = 47), or pasireotide if uncontrolled under first-generation SRLs (group 2; n = 9). Data were collected at baseline and months 3 and 6. Biochemical measurements, immunohistochemistry studies, and MRI readings were centralized. Results In group 1, IGF-I decrease from baseline to month 6 positively correlated with SST2A immunoreactive score (IRS), P = 0.01. Densely granulated/intermediate adenomas had a greater IGF-I and GH decrease under octreotide compared with sparsely granulated adenomas (P = 0.02 and P = 0.006, respectively), and expressed greater levels of SST2A (P < 0.001), coupled with lower levels of SST5 (P = 0.004). T2WSI changed between preoperative MRI and month 6 MRI in one-half of the patients. Finally, SST5 IRS was higher in preoperative hyperintense compared with preoperative hypointense adenomas (P = 0.04), and most sparsely granulated and most hyperintense adenomas expressed high SST5 levels. Conclusion We prospectively confirm that SST2A and adenoma granularity are good predictors of response to octreotide. We propose the IRS for scoring system harmonization. MRI sequences must be optimized to be able to use the T2WSI as a predictor of treatment response.
Fichier principal
Vignette du fichier
Predictive Factors of Somatostatin Receptor Ligand Response in Acromegaly—A Prospective Study_JCEM_09 2022.pdf (880.41 Ko) Télécharger le fichier
Origine : Fichiers produits par l'(les) auteur(s)

Dates et versions

hal-04045506 , version 1 (12-04-2023)

Identifiants

Citer

Mirela-Diana Ilie, Antoine Tabarin, Alexandre Vasiljevic, Jean-François Bonneville, Lucile Moreau-Grangé, et al.. Predictive Factors of Somatostatin Receptor Ligand Response in Acromegaly—A Prospective Study. Journal of Clinical Endocrinology and Metabolism, 2022, 107 (11), pp.2982-2991. ⟨10.1210/clinem/dgac512⟩. ⟨hal-04045506⟩
63 Consultations
92 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More