Revisiting the usefulness of the short acute octreotide test to predict treatment outcomes in acromegaly
Por:
Marques-Pamies, M, Gil, J, Valassi, E, Hernández, M, Biagetti, B, Giménez-Palop, O, Martínez, S, Carrato, C, Pons, L, Villar-Taibo, R, Araujo-Castro, M, Blanco, C, Simón, I, Simó-Servat, A, Xifra, G, Vázquez, F, Pavón, I, García-Centeno, R, Zavala, R, Hanzu, FA, Mora, M, Aulinas, A, Vilarrasa, N, Librizzi, S, Calatayud, M, de Miguel, P, Alvarez-Escola, C, Picó, A, Sampedro, M, Salinas, I, Fajardo-Montañana, C, Cámara, R, Bernabéu, I, Jordà, M, Webb, SM, Marazuela, M, Puig-Domingo, M
Publicada:
31 oct 2023
Resumen:
Introduction: We previously described that a short version of the acute octreotide test (sAOT) can predict the response to first-generation somatostatin receptor ligands (SRLs) in patients with acromegaly. We have prospectively reassessed the sAOT in patients from the ACROFAST study using current ultra-sensitive GH assays. We also studied the correlation of sAOT with tumor expression of E-cadherin and somatostatin receptor 2 (SSTR2) .Methods: A total of 47 patients treated with SRLs for 6 months were evaluated with the sAOT at diagnosis and correlated with SRLs' response. Those patients whose IGF1 decreased to <3SDS from normal value were considered responders and those whose IGF1 was >= 3SDS, were considered non-responders. The 2 hours GH value (GH2h) after s.c. administration of 100 mcg of octreotide was used to define predictive cutoffs. E-cadherin and SSTR2 immunostaining in somatotropinoma tissue were investigated in 24/47 and 18/47 patients, respectively.Results: In all, 30 patients were responders and 17 were non-responders. GH(2h) was 0.68 (0.25-1.98) ng/mL in responders vs 2.35 (1.59-9.37) ng/mL in non-responders (p<0.001). GH(2h) = 1.4ng/mL showed the highest ability to identify responders (accuracy of 81%, sensitivity of 73.3%, and specificity of 94.1%). GH(2h) = 4.3ng/mL was the best cutoff for non-response prediction (accuracy of 74%, sensitivity of 35.3%, and specificity of 96.7%). Patients with E-cadherin-positive tumors showed a lower GH(2h) than those with E-cadherin-negative tumors [0.9 (0.3-2.1) vs 3.3 (1.5-12.1) ng/mL; p<0.01], and patients with positive E-cadherin presented a higher score of SSTR2 (7.5 +/- 4.2 vs 3.3 +/- 2.1; p=0.01).Conclusion: The sAOT is a good predictor tool for assessing response to SRLs and correlates with tumor E-cadherin and SSTR2 expression. Thus, it can be useful in clinical practice for therapeutic decision-making in patients with acromegaly.
Filiaciones:
Marques-Pamies, M:
Hosp Municipal Badalona, Dept Endocrinol & Nutr, Badalona, Spain
Gil, J:
Germans Trias & Pujol Res Inst IGTP, Endocrine Res Unit, Badalona, Spain
Inst Salud Carlos III ISCIII, Ctr Invest Biomed Red Enfermedades Raras CIBER ER, Unidad 747, Barcelona, Spain
Valassi, E:
Germans Trias & Pujol Res Inst IGTP, Endocrine Res Unit, Badalona, Spain
Inst Salud Carlos III ISCIII, Ctr Invest Biomed Red Enfermedades Raras CIBER ER, Unidad 747, Barcelona, Spain
Germans Trias & Pujol Univ Hosp, Dept Endocrinol & Nutr, Badalona, Spain
Hernández, M:
Arnau de Vilanova Univ Hosp, Dept Endocrinol & Nutr, Lleida, Spain
Lleida Inst Biomed Res Dr Pifarre Fdn IRBLleida, Endocrine Res Unit, Lleida, Spain
Biagetti, B:
Vall Hebron Univ Hosp, Dept Endocrinol & Nutr, Barcelona, Spain
Giménez-Palop, O:
Parc Tauli Univ Hosp, Dept Endocrinol & Nutr, Sabadell, Spain
Martínez, S:
Germans Trias & Pujol Univ Hosp, Dept Hormonal Lab, Badalona, Spain
Carrato, C:
Germans Trias & Pujol Univ Hosp, Dept Pathol, Badalona, Spain
Pons, L:
Germans Trias & Pujol Univ Hosp, Dept Pathol, Badalona, Spain
Villar-Taibo, R:
Clin Santiago Univ Hosp, Dept Endocrinol & Nutr, Santiago De Compostela, Spain
Araujo-Castro, M:
Ramon & Cajal Univ Hosp, Dept Endocrinol & Nutr, Madrid, Spain
Blanco, C:
Principe de Asturias Univ Hosp, Dept Endocrinol & Nutr, Madrid, Spain
Simón, I:
Joan XXIII Univ Hosp, Dept Endocrinol & Nutr, Tarragona, Spain
Simó-Servat, A:
Mutua de Terrassa Univ Hosp, Dept Endocrinol & Nutr, Terrassa, Spain
Xifra, G:
Josep Trueta Univ Hosp, Dept Endocrinol & Nutr, Girona, Spain
Vázquez, F:
Germans Trias & Pujol Univ Hosp, Dept Endocrinol & Nutr, Badalona, Spain
Pavón, I:
Getafe Univ Hosp, Dept Endocrinol & Nutr, Madrid, Spain
García-Centeno, R:
Gregorio Maranon Univ Hosp, Dept Endocrinol & Nutr, Madrid, Spain
Zavala, R:
Joan XXIII Univ Hosp, Dept Endocrinol & Nutr, Tarragona, Spain
Hanzu, FA:
Hosp Clin Univ Hosp, Dept Endocrinol & Nutr, Barcelona, Spain
Inst Invest Biomed August Pi & Sunyer IDIBAPS, Endocrine Res Unit, Barcelona, Spain
Mora, M:
Hosp Clin Univ Hosp, Dept Endocrinol & Nutr, Barcelona, Spain
Inst Invest Biomed August Pi & Sunyer IDIBAPS, Endocrine Res Unit, Barcelona, Spain
Aulinas, A:
Inst Salud Carlos III ISCIII, Ctr Invest Biomed Red Enfermedades Raras CIBER ER, Unidad 747, Barcelona, Spain
Hosp Santa Creu & Sant Pau, Dept Endocrinol & Nutr, Barcelona, Spain
Univ Autonoma Barcelona UAB, Dept Med, Barcelona, Spain
Vilarrasa, N:
Bellvitge Univ Hosp, Dept Endocrinol & Nutr, Bellvitge, Spain
Inst Invest Biomed Bellvitge IDIBELL, Endocrine Res Unit, Bellvitge, Spain
Inst Salud Carlos III ISCIII, Ctr Invest Biomed Red Diabet & Enfermedades Metab, Madrid, Spain
Librizzi, S:
12 Octubre Univ Hosp, Dept Endocrinol & Nutr, Madrid, Spain
Calatayud, M:
12 Octubre Univ Hosp, Dept Endocrinol & Nutr, Madrid, Spain
de Miguel, P:
Clinico San Carlos Univ Hosp, Dept Endocrinol & Nutr, Madrid, Spain
Alvarez-Escola, C:
La Paz Univ Hosp, Dept Endocrinol & Nutr, Madrid, Spain
Picó, A:
Miguel Hernandez Univ, Gen Univ Hosp Dr Balmis, Dept Endocrinol & Nutr, Alicante, Spain
Inst Invest Sanitaria & Biomed Alicante ISABIAL, Endocrine Res Unit, Alicante, Spain
Sampedro, M:
La Princesa Univ Hosp, Dept Endocrinol & Nutr, Madrid, Spain
Salinas, I:
Germans Trias & Pujol Univ Hosp, Dept Endocrinol & Nutr, Badalona, Spain
Fajardo-Montañana, C:
La Ribera Univ Hosp, Dept Endocrinol & Nutr, Valencia, Spain
Cámara, R:
La Fe Univ Hosp, Dept Endocrinol & Nutr, Valencia, Spain
Bernabéu, I:
Clin Santiago Univ Hosp, Dept Endocrinol & Nutr, Santiago De Compostela, Spain
Jordà, M:
Germans Trias & Pujol Res Inst IGTP, Endocrine Res Unit, Badalona, Spain
Webb, SM:
Inst Salud Carlos III ISCIII, Ctr Invest Biomed Red Enfermedades Raras CIBER ER, Unidad 747, Barcelona, Spain
Hosp Santa Creu & Sant Pau, Dept Endocrinol & Nutr, Barcelona, Spain
Univ Autonoma Barcelona UAB, Dept Med, Barcelona, Spain
Marazuela, M:
La Princesa Univ Hosp, Dept Endocrinol & Nutr, Madrid, Spain
Puig-Domingo, M:
Germans Trias & Pujol Res Inst IGTP, Endocrine Res Unit, Badalona, Spain
Inst Salud Carlos III ISCIII, Ctr Invest Biomed Red Enfermedades Raras CIBER ER, Unidad 747, Barcelona, Spain
Germans Trias & Pujol Univ Hosp, Dept Endocrinol & Nutr, Badalona, Spain
Univ Autonoma Barcelona UAB, Dept Med, Barcelona, Spain
gold
|