Long-term treatment of acromegaly with the somatostatin analogue SR-lanreotide

Suliman, Mohamed; Jenkins, Richard C.; Ross, Richard; Powell, T.; Battersby, R D; Cullen, D. R.

doi:10.1007/bf03343583

Cited by 56 publications

(33 citation statements)

References 26 publications

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“…In agreement with other trials with lanreotide SR (16,22,25), we observed a small rise in fasting blood glucose during therapy, whereas others found no change in glucose metabolism (23). In our study, as well as in others (22,23), no obvious deterioration in glucose metabolism was seen in patients with overt diabetes.…”

Section: Discussionsupporting

confidence: 93%

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Slow-release lanreotide in the treatment of acromegaly: a study in 66 patients

Verhelst

Pedroncelli²,

Abs³

et al. 2000

European Journal of Endocrinology

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Objective: Slow-release (SR) lanreotide is a long-acting somatostatin analog that has been developed in order to overcome the inconvenience of multiple daily subcutaneous injections of octreotide, required for metabolic control in acromegaly. Lanreotide SR has been found to be well tolerated and effective in reducing GH and IGF-I levels but clinical data are still limited compared with those with subcutaneous octreotide treatment. Design: Sixty-six unselected patients with active acromegaly were therefore evaluated in a multi-center, prospective, open label study. Lanreotide SR was given at a dose of 30 mg intramuscular every 7±14 days. Methods: At baseline and after 2, 4, 8, 12, 24, 36 and 48 weeks patients underwent a clinical examination with assessment of acromegaly related symptoms, and blood was sampled for serum GH, IGF-I, prolactin, glycosylated hemoglobin, fasting glucose, hematology, kidney function and liver function tests. Biliary ultrasonography and pituitary magnetic resonance imaging were performed at baseline and after one year.

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Section: Discussionsupporting

confidence: 93%

“…Apart from octreotide sensitivity, response to treatment was not in¯uenced by sex, previous surgery nor previous radiotherapy, similar to the experience in other studies (25). Patients whose GH or IGF-I levels were not normalized tended to have higher pre-treatment levels, but the difference was not signi®cant.…”

Section: Discussionsupporting

confidence: 81%

Slow-release lanreotide in the treatment of acromegaly: a study in 66 patients

Verhelst

Pedroncelli²,

Abs³

et al. 2000

European Journal of Endocrinology

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“…In contrast, Bevan (37) estimated that, of 921 cases included in the analysis, 20 -or 2.2% -had tumor growth on somatostatin analogs (37). Failure to control pituitary adenoma growth occurred in approximately 10% in individual studies using lanreotide (38,39) and octreotide (40), which were not included in that analysis. Another issue that may confound accurate analysis of tumor behavior in general is the fluctuation in tumor size to the order of 10 -20%, which can be seen during intensive MRI follow-up in individual acromegalic patients treated with somatostatin analogs (33).…”

Section: Medical Therapymentioning

confidence: 99%

Predictors and rates of treatment-resistant tumor growth in acromegaly

2005

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Background: Multimodal therapy for acromegaly affords adequate disease control for many patients; however, there remains a subset of individuals that exhibit treatment-resistant disease. The issue of treatment-resistant pituitary tumor growth remains relatively under-explored. Methods: We assessed the literature for relevant data regarding the surgical, medical and radiotherapeutic treatment of acromegaly in order to identify the factors that were predictive of aggressive or treatment-resistant pituitary tumor behavior in acromegaly and undertook an assessment of the rates of failure to control tumor progression with available treatment modalities. Results: Young age at diagnosis, large tumor size, high growth hormone secretion and certain histological markers are predictors of future aggressive tumor behavior in acromegaly. Significant tumor regrowth occurs in less than 10% of cases thought to be cured surgically, whereas failure to control tumor growth is seen in less than 1% of patients receiving radiotherapy. Somatostatin analogs induce a variable degree of tumor shrinkage in acromegaly but up to 2.2% of somatostatin analog-treated tumors continue to grow. Relative to other therapies, limited data are available for pegvisomant, but these indicate that persistent tumor growth occurs in 1.6 -2.9% of cases followed up regularly with serial magnetic resonance imaging scans. Conclusions: Treatment-resistant tumor progression occurs in a small minority of patients with acromegaly, regardless of treatment modality. Young patients with large tumors or those with high pre-treatment levels of growth hormone particularly warrant close monitoring for continued tumor progression during treatment for acromegaly.

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“…Such biomarkers include the acute octreotide test, the presence of a gsp mutation, the expression of E-cadherin, the expression of sst5 and its truncated isoform (sst5TMD4), the expression of miR-34a, the expression of β-arrestin, the Ki-67 labeling index and the Raf kinase expression 57,68,72,83,[86][87][88][89][90][91] . Additionally, some demographic characteristics, such as younger age, male gender and high pretreatment GH levels were associated with a poor response to fg-SRL in some studies [92][93][94] .…”

Section: Biomarkers Of Treatment Response In Acromegalymentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Personalized medicine in the treatment of acromegaly

Kasuki

Wildemberg

2018

European Journal of Endocrinology

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Acromegaly is associated with high morbidity and elevated mortality when not adequately treated. Surgery is the first-line treatment for most patients as it is the only one that can lead to immediate cure. In patients who are not cured by surgery, treatment is currently based on a trial-and-error approach. Firstgeneration somatostatin receptor ligands (fg-SRL) are initiated for most patients, although approximately 25% of patients present resistance to this drug class. Some biomarkers of treatment outcome are described in the literature, with the aim of categorizing patients into different groups to individualize their treatments using a personalized approach. In this review, we will discuss the current status of precision medicine for the treatment of acromegaly and future perspectives on the use of personalized medicine for this purpose.

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Long-term treatment of acromegaly with the somatostatin analogue SR-lanreotide

Abstract: Long-term treatment of acromegaly with SR-lanreotide is effective in controlling GH and IGF-I levels and symptoms and is well tolerated in the majority of patients.

Cited by 56 publications

References 26 publications

Slow-release lanreotide in the treatment of acromegaly: a study in 66 patients

Slow-release lanreotide in the treatment of acromegaly: a study in 66 patients

Predictors and rates of treatment-resistant tumor growth in acromegaly

MANAGEMENT OF ENDOCRINE DISEASE: Personalized medicine in the treatment of acromegaly

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