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Open access

Hélène Lasolle, Amandine Ferriere, Alexandre Vasiljevic, Sandrine Eimer, Marie-Laure Nunes and Antoine Tabarin

Purpose: Little data is available regarding the safety and efficacy of switching to Pasireotide-LAR monotherapy in acromegaly patients with partial resistance to first generation somatostatin agonists (1gSRL) who require combination treatment with cabergoline or pegvisomant.

Method: In this monocentric prospective study within a tertiary university hospital, fifteen consecutive acromegalic adults partially resistant to 1gSRL treated with octreotide LAR or lanreotide SR, and cabergoline (N = 4, 3.5 mg/wk) or pegvisomant (N = 11, median dose 100 mg/wk), were switched to Pasireotide-LAR (8 with 40mg/Mo; 7 with 60 mg/Mo). Immunohistochemical expression level of SSTR5 and the granulation pattern of 9 somatotroph adenomas were retrospectively determined to test for a correlation with the therapeutic efficacy of Pasireotide-LAR.

Results: Median IGF-1 concentration at the first evaluation (median 3 Mo) was similar to baseline (1.0 vs 1.1 ULN). 11/15 patients had IGF-1 levels ≤ 1.3 ULN before and after the switch but individual changes were variable. Hyperglycemia was frequent and greater in diabetic patients. 7/15 patients stopped Pasireotide-LAR due to lack of control of IGF-1 or intolerance. 8/15 patients received Pasireotide-LAR for a median of 29 months with IGF-1 levels ≤ 1.3 ULN and acceptable glucose tolerance (median HbA1c 6.1%). 2 patients required initiation of oral antidiabetic treatment. The intensity of SSTR5 expression and the granulation pattern of adenomas were of limited value for the prediction of Pasireotide-LAR effectiveness.

Conclusion: Pasireotide-LAR may represent a suitable therapeutic alternative in a subset of acromegalic patients requiring combination therapy involving a 1gSRL.

Open access

G Giuffrida, F Ferraù, R Laudicella, O R Cotta, E Messina, F Granata, F F Angileri, A Vento, A Alibrandi, S Baldari and S Cannavò

receptor radionuclide therapy (PRRT) ( 7 ). The expression of different subtypes of somatostatin receptors (SSTR, mainly 1, 2 and 5 subtype) on PT cells constitute the pathophysiological basis of their treatment with first generation (octreotide, lanreotide

Open access

David P Sonne, Asger Lund, Jens Faber, Jens J Holst, Tina Vilsbøll and Filip K Knop

expression (at 62 h) (31) . However, D2 activities were very low and were not influenced by hypothyroidism, fasting or insulin. Another explanation for the acute post-prandial TSH decline observed in this study could be somatostatin being released

Open access

A V Dreval, I V Trigolosova, I V Misnikova, Y A Kovalyova, R S Tishenina, I A Barsukov, A V Vinogradova and B H R Wolffenbuttel

may also influence the development of glucose disturbances is the specific treatment for acromegaly. Somatostatin analogues may influence glucose metabolism both by lowering insulin secretion and by lowering GH and IGF1 levels (13, 14) . The aim of

Open access

Kosmas Daskalakis, Marina Tsoli, Anna Angelousi, Evanthia Kassi, Krystallenia I Alexandraki, Denise Kolomodi, Gregory Kaltsas and Anna Koumarianou

administered to patients who experienced disease progression during watchful waiting or treatment with either somatostatin analogues (SSAs) or chemotherapy. Second-line (sequential) MTT with sunitinib or everolimus was administered in a subset of NEN patients

Open access

Annieke C G van Baar, Andrei Prodan, Camilla D Wahlgren, Steen S Poulsen, Filip K Knop, Albert K Groen, Jacques J Bergman, Max Nieuwdorp and Evgeni Levin

). On the other hand, somatostatin is produced by delta cells (D cells) in the gastrointestinal tract. Somatostatin reduces gastric acid production and slows down the digestive process by suppressing the release of GIP, insulin and glucagon. To date, it

Open access

Ashley K Clift, Omar Faiz, Robert Goldin, John Martin, Harpreet Wasan, Marc-Olaf Liedke, Erik Schloericke, Anna Malczewska, Guido Rindi, Mark Kidd, Irvin M Modlin and Andrea Frilling

) and AJCC/UICC ( 16 ) criteria. Tumour staging was based on results of standard cross-sectional imaging and somatostatin receptor-based imaging; in the initial phase of the study this was somatostatin receptor scintigraphy and more recently, positron

Open access

Benjamin G Challis, Andrew S Powlson, Ruth T Casey, Carla Pearson, Brian Y Lam, Marcella Ma, Deborah Pitfield, Giles S H Yeo, Edmund Godfrey, Heok K Cheow, V Krishna Chatterjee, Nicholas R Carroll, Ashley Shaw, John R Buscombe and Helen L Simpson

realised with supplementary carbohydrates alone. Refractory hypoglycaemia may be successfully treated with adjunctive therapeutics including diazoxide, somatostatin analogues or mammalian target of rapamycin (mTOR) inhibitors ( 4 , 5 ). Although these

Open access

Gaëtan Prévost, Marie Picot, Marie-Anne Le Solliec, Arnaud Arabo, Hind Berrahmoune, Mouna El Mehdi, Saloua Cherifi, Alexandre Benani, Emmanuelle Nédélec, Françoise Gobet, Valéry Brunel, Jérôme Leprince, Hervé Lefebvre, Youssef Anouar and Nicolas Chartrel

, treatment of consecutive sections with the 26RFa antibodies and somatostatin antibodies revealed that some somatostatin-producing cells expressed 26RFa ( Fig. 6F and G ). Figure 6 Co-distribution of 26RFa-like immunoreactivity (LI) with insulin

Open access

Magaly Zappa, Olivia Hentic, Marie-Pierre Vullierme, Matthieu Lagadec, Maxime Ronot, Philippe Ruszniewski and Valérie Vilgrain

). Several recently published studies have shown that liver tumour burden was an important factor for patient management and long-term outcome, especially for somatostatin analogue treatment, and also for transarterial chemoembolisation, bland embolisation or