ECE2022 Poster Presentations Pituitary and Neuroendocrinology (127 abstracts)
Predictive factors of somatostatin receptor ligand response in acromegaly – a prospective study
Mirela Diana Ilie 1,2 , Antoine Tabarin 3 , Alexandre Vasiljevic 4 , Bonneville Jean-Francois 5 , Lucile Moreau-Grangé 6 , Franck Schillo 7 , Brigitte Delemer 8 , Anne Barlier 9 , Dominique Figarella-Branger 10 , Ségolène Bisot-Locard 11 , Alexandre Santos 11 , Philippe Chanson 12 & Gerald Raverot 4
1Claude Bernard University Lyon 1, Villeurbanne, France; 2C.I. Parhon National Institute of Endocrinology, Bucureşti, Romania; 3Hospital Center University De Bordeaux, Bordeaux, France; 4Group Hospital Is - Hcl, Bron, France; 5Hospital Center Universitaire De Liège, Luik, Belgium; 6Hospital Center University De Rouen, Rouen, France; 7Centre Hospitalier Régional Universitaire de Besançon, Besançon, France; 8CHU of Reims - Maison Blanche Hospital, Reims, France; 9Conception, Marseille, France; 10CHU Timone, Marseille, France; 11Novartis Pharma, Rueil-Malmaison, France; 12Bicetre Hospital, Le Kremlin-Bicêtre, France
Context: Somatostatin receptor ligands (SRLs) are the cornerstone medical treatment of acromegaly, however many patients remain uncontrolled under SRLs. Well-established predictive markers of response are needed.
Objective: We aimed to explore the relationship between responsiveness to SRLs, on one hand, and somatostatin (SST)2A and 5 receptor expression, adenoma granulation, and T2-weighted MRI signal intensity (T2WSI), on the other hand.
Design: Multicentric, prospective, observational cohort study, conducted in France.
Methods: Forty-nine naive patients with active acromegaly following surgery were treated with octreotide (Group 1; n=47), or pasireotide if also uncontrolled under first-generation SRL (Group 2; n=9). Data was collected at baseline, month 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 greater IGF-I and GH decrease under octreotide than sparsely granulated adenomas (P=0.02 andP=0.006, respectively), and expressed greater levels of SST2A (P<0.001), coupled with lower levels of SST5 (P=0.004). T2WSI changed between the preoperative MRI and month 6-MRI in half of the patients. SST5 IRS was higher in hyperintense than in hypointense adenomas (preoperative MRI), P=0.04. 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, and that SST5 is not. We propose the IRS for scoring system harmonization. The MRI sequences must be optimized in order to be able to use the T2WSI as a predictor of response to treatment.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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