ECE2024 Poster Presentations Pituitary and Neuroendocrinology (120 abstracts)
Differences in the efficacy of second-line therapies on the biochemical control of acromegaly in patients with GH secreting pituitary neuroendocrine tumors (Pit-NETs) and GH and PRL cosecreting Pit-NETs
Marta Araujo Castro 1 , Almudena Vicente 2 , Fernando Cordido 3 , Edelmiro Luis Menendez Torre 4 , Eider Pascual-Corrales 1 , Eva Venegas Moreno 5 , Rogelio García Centeno 6 , Rocio Villar Taibo 7 , Fernando Guerrero 8 , Pablo Abellán Galiana 9 , Felicia A Hanzu 10 , Carmen Fajardo-Montañana 11 , Cristina Novo 12 , Rosa Camara 13 , Maria Dolores Aviles Perez 14 , Mónica Marazuela 15 , Betina Biagetti 16 & Manel Puig-Domingo 17
1Ramón y Cajal Hospital, Endocrinology & Nutrition, Madrid, Spain; 2Hospital Universitario de Toledo, Endocrinology & Nutrition, Toledo, Spain; 3Hospital Universitario de Coruña, Coruña, Spain; 4Hospital Universitario Central de Asturias, Asturias, Spain; 5Hospital Universitario Virgen del Rocío, Sevilla, Spain; 6Hospital Gregorio Marañón, Madrid, Spain; 7Hospital Santiago de Compostela, Spain; 8Hospital Universitari de Bellvitge., Spain; 9Hospital Universitario de Castellón, Spain; 10Hospital Clinic de Barcelona, Spain; 11Hospital Ribera, Spain; 12Hospital Virgen de las Nieves, Spain; 13Hospital Universitario La Fe, Spain; 14Hospital Universitario San Cecilio., Spain; 15Hospital Universitario la Princesa, Spain; 16Hospital Universitario Vall d’Hebrón, Spain; 17Hospital Germans Trias i Pujol, Spain
Aim: To evaluate the efficacy of second-line therapies in patients with acromegaly caused by a GH and PRL cosecreting pituitary neuroendocrine tumor (GH&PRL-Pit-NET) and those caused by a GH-Pit-NET.
Methods: A multicenter retrospective clinical practice study of 679 patients with acromegaly in follow-up in 33 tertiary hospitals (ACRO-SPAIN study). For this analysis, only patients on treatment with pasireotide or pegvisomant in monotherapy or in combination with other drugs were included (n=150; 22.1%). Patients were classified in two groups: GH-Pit-NET if PRL levels were normal (n=122) and GH&PRL-Pit-NET when evidence of hyperprolactinemia and immunohistochemistry (IHC) for GH and PRL was positive or if PRL levels were >100ng/dl regardless of the PRL IHC (n=28).
Results: A total of 150 patients with acromegaly accomplish the inclusion criteria. A total of 124 patients were treated with pegvisomant and 49 with pasireotide at any time (Table 1). The median time of treatment was of 30.8 months (IQR=15.9-58.2) with pasireotide and 100 months (IQR=34.4-138.5) with pegvisomant. No differences in IGF1 control with pasireotide neither with pegvisomant were observed between GH&PRL-Pit-NETs and GH-Pit-NETs (Table 1). All GH&PRL-Pit-NET cases treated with pasireotide (n=6) and 82.6% (n=19/23) of the cases treated with pegvisomant normalized PRL levels. No differences in the rate of IGF1 control between pegvisomant (in monotherapy or combined with dopamine agonists) vs pasireotide (in monotherapy or combined with dopamine agonists) were detected in patients with GH&PRL-Pit-NET (84.9% vs 66.7%, P=0.178). Neither in the rate of PRL control (80% vs 100%, P=0.234).
| GH-Pit-NET (n=122) | GH&PRL-Pit-NET (n=28) | P value | |
| CLINICO-RADIOLOGICAL DATA AT ACROMEGALy DIAGNOSIS | |||
| Age (years) | 46.2±16.03 | 38.0±13.77 | 0.017 |
| Knosp>2 (n=118) | 51.7% (n=47/91) | 74.1% (n=20/27) | 0.039 |
| EFFICACy OF SECOND-LINE MEDICAL THERAPIES (IGF normalization) | |||
| Pasireotide monotherapy or combined with DA (n=43) | 66.7% (n=24/36) | 71.4% (n=5/7) | 0.806 |
| Pasireotide monotherapy (n=24) | 69.6% (n=16/23) | 100% (n=1) | 0.512 |
| Pasireotide+DA | 61.5% (n=8/13) | 66.7% (n=4/6) | 0.829 |
| Pegvisomant monotherapy or combined with DA/f-SRL (n=118) | 84.4% (n=81/96) | 77.3% (n=17/22) | 0.423 |
| Pegvisomant monotherapy (n=45) | 85.7% (n=30/35) | 80% (n=8/10) | 0.660 |
| Pegvisomant+f-SRL (n=43) | 79.5% (n=31/39) | 100% (n=4) | 0.315 |
| Pegvisomant+DA (n=20) | 86.7% (n=13/15) | 60% (n=3/5) | 0.197 |
| Pegvisomant+pasireotide (n=6) | 40% (n=2/5) | 100% (n=1) | 0.273 |
| DA=dopamine agonists; f-SRL= first generation somatostatin receptor ligands | |||
Conclusion: GH&PRL-Pit-NETs are invasive tumors and present at a younger age than GH-Pit-NETs. However, no differences in the rate of IGF-1 biochemical control with second line therapies were observed between both groups.
Article tools
My recent searches
My recently viewed abstracts
Authors
Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
© Bioscientifica 2024 |
Privacy policy |
Cookie settings
BiosciAbstracts
Bioscientifica Abstracts is the gateway to a series of products that provide a permanent, citable record of abstracts for biomedical and life science conferences.
Find out more