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- Title
Revisiting the usefulness of the short acute octreotide test to predict treatment outcomes in acromegaly.
- Authors
Marques-Pamies, Montserrat; Gil, Joan; Valassi, Elena; Hernández, Marta; Biagetti, Betina; Giménez-Palop, Olga; Martínez, Silvia; Carrato, Cristina; Pons, Laura; Villar-Taibo, Rocío; Araujo-Castro, Marta; Blanco, Concepción; Simón, Inmaculada; Simó-Servat, Andreu; Xifra, Gemma; Vázquez, Federico; Pavón, Isabel; García-Centeno, Rogelio; Zavala, Roxana; Hanzu, Felicia Alexandra
- Abstract
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 fromnormal 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. GH2h 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). GH2h = 1.4ng/mL showed the highest ability to identify responders (accuracy of 81%, sensitivity of 73.3%, and specificity of 94.1%). GH2h = 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 GH2h 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.
- Subjects
CADHERINS; ACROMEGALY; SOMATOSTATIN receptors; TREATMENT effectiveness; IMMUNOSTAINING
- Publication
Frontiers in Endocrinology, 2023, p1
- ISSN
1664-2392
- Publication type
Article
- DOI
10.3389/fendo.2023.1269787