Endocrine Abstracts

The dopamine agonist cabergoline has been found to be effective in inducing normalization of cortisol secretion in 25–50% of patients with Cushing’s disease after long-term treatment. Moreover, tumor shrinkage have been documented in selected patients with pituitary corticotroph tumors. The aim of the present study was to evaluate the effect of cabergoline withdrawal in patients with a stable normalization of cortisol secretion and stable or absent visualization of p...

Subclinical Cushing’s syndrome (SCS) is a mild autonomous cortisol hypersecretion without specific clinical syndrome of glucocorticoid excess. The aim of this study was to compare cardiac structure and function in patients with adrenal incidentaloma. Twenty patients and 20 sex- and age-matched healthy controls entered the study: among patients, 11 had SCS and the remaining nine had normal cortisol secretion All patients and controls were submitted to Doppler echocardiogra...

Acromegaly is known to be associated to an increased cardiovascular risk, due to the increased prevalence of glucose intolerance and dyslipidemia and pre-atherosclerotic lesions. The aim of this study was to evaluate the effect of treatment with the GH receptor antagonist pegvisomant on cardiovascular risk and atherosclerosis in patients with acromegaly resistant to somatostatin analogues. Twelve patients (4 m, 8 f, 28–58 yrs) and 24 sex-, age- and BMI-matched controls en...

Dopamine agonists have been used as first or adjunctive therapy for acromegaly for many years, but relatively few studies have assessed the efficacy of a newer agonist, cabergoline (CAB) alone or in combination with somatostatin analogues (SSA). The aim of this study was to evaluate the efficacy of combined treatment with SSA plus CAB in patients with acromegaly and resistance to SSA, defined as lack of normalization of IGF-I levels after long-term (>1 year) and hig...

Conventional glucocorticoids (CGCs) are unable to mimic physiological cortisol rhythm in adrenal insufficiency (AI), resulting in increased metabolic morbidity and impaired quality of life (QoL). Non-physiological cortisol pattern and elevated evening cortisol levels may be responsible for the increased risk of metabolic disorders observed in AI patients under CGCs. Once daily dual-release-hydrocortisone (DR-HC), which better reproduces physiological daily cortisol profile, si...

Conventional glucocorticoids (GCs) are unable to mimic physiological cortisol rhythm in adrenal insufficiency (AI), with a significant impact on morbidity and mortality. Possible explanations are supra-physiological doses and impaired cortisol profile. In particular, elevated evening cortisol levels were related to glucose tolerance and insulin sensitivity alterations and visceral obesity. Once-daily-dual-release-hydrocortisone (OD-DR-HC), better reproducing the physiological ...

HCC is one of the most common malignancies worldwide. Local approaches are generally preferred for patients whose disease is restricted to the liver. In patients with extrahepatic disease systemic therapy can be considered. Chemotherapy did not demonstrate convincing survival advantages in several trails for HCC patients. Presently, the kinase inhibitor sorafenib is the only approved systemic target therapy for the treatment of advanced HCC. Mitotane (dichlorodiphenildichloroe...

HCC is a difficult-to-treat- cancer with poor prognosis. The recent EVOLVE-1 trial demonstrated that EVE did not improve overall survival in molecularly and clinically unselected patients with advanced HCC resistant to sorafenib treatment. In selected patients, the well-established antitumor effect of EVE could make this drug a potential adjuvant therapy. Unfortunately, the acquired resistance to this molecule due to the tumor adaptation to chronic drug use is a current challe...

In patients with congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency, life-long glucocorticoid (GC) treatment is often required to replace cortisol deficiency and to avoid the ACTH-dependent androgen levels increase. However, in these patients, the multiple daily doses required with conventional GCs can cause cortisol overexposure, leading to an increased risk of metabolic syndrome (MS), an impaired quality of life (QoL), and poor treatment compliance (TC). T...

Adrenocortical cancer (ACC) is a rare cancer with poor prognosis and scant treatment options. Mitotane alone, or in combination with cytotoxic chemotherapy, represents the referral current treatment for patients with unresectable ACC. Recent studies have shown that mTOR inhibitors suppress growth of ACC cells. This study aimed at evaluating the effects of mitotane in combination with mTOR inhibitors. In H295 and SW13 cells we tested the effects of a 6 day treatment with increa...