Signifor (pasireotide)

Despite multimodal therapy (lanreotide, cabergoline, two debulking surgeries), disease control was achieved only after pasireotide and adjuvant proton therapy. The same variant was found in her father, who had a smaller intrasellar macroadenoma causing acromegaly. This familial observation provides the functional evidence that MAX is a driver in GH-PitNET and a candidate gene for PitNET predisposition.

P1, N=40, Recruiting, RECORDATI GROUP

Patient 2, 48-year-old male with a significant macroadenoma and prior cabergoline treatment, achieved partial biochemical control. Four out of these five patients showed reduction in tumour size. This case series corroborates the findings from previous studies, adding insight into treatment challenges and benefits experienced by this heterogeneous group of patients on pasireotide.

In conclusion, our results suggest that FLNA may be associated with tumor invasiveness in GH-secreting pituitary tumors. While data on Pasireotide-treated patients are exploratory, further studies are needed to assess FLNA's potential as a treatment response marker in acromegaly.

It may indicate advanced disease and, if confirmed in other cohorts, could be considered among the suggestive signs of acromegaly. In our case, the use of pasireotide allowed adherence to therapy and optimal therapeutic response in a multicomplicated, non-self-sufficient patient.

Considering pasireotide's potential to target c-MET and EGFR pathways, our findings provide a strong rationale for its further preclinical validation in the treatment of TNBC. The demonstrated efficacy and safety of pasireotide in this aggressive subtype of cancer can now be evaluated through subsequent studies.

Recent studies have shown that first- and second-generation somatostatin receptor ligands (SRLs) can reduce the incidence of vertebral fractures (i-VFs). However, a direct effect of these molecules on bone metabolism has not yet been reported. Aims: This review summarizes the results of studies investigating the frequency of i-VFs according to different GH/IGF-I-lowering drugs and the potential effects of these treatments on bone metabolism, as well as preclinical data on potential molecular pathways that interact between GH/IGF-I-lowering drugs and bone metabolism.

ACROFAST has laid critical groundwork by demonstrating how the combination of predictive biomarkers enhances therapeutic outcomes, improving the rate of biochemical remission and in a shorter follow-up period. In addition, the application of artificial intelligence and machine learning algorithms trained on multiomic and clinical datasets may be useful to improve outcomes and reduce the trial-and-error nature of current pharmacologic management of acromegaly.

P2, N=93, Active, not recruiting, RECORDATI GROUP | Recruiting --> Active, not recruiting

Pasireotide appears to induce durable cystic degeneration in somatotroph tumours, with evidence suggesting sustained antitumor effects that may extend beyond treatment discontinuation. These findings support its potential for a broader therapeutic role, warranting validation in future prospective studies.

Sensitivity analyses are planned for both age groups and disease types. EUCT: 2024-511935-86-00-00; ClinicalTrials.gov: NCT06456359.

The aim of this study is to assess the cost-utility of second-line treatments of acromegaly accounting for the overall management recommended in France, considering surgery, first-line treatments, radiotherapy and the impact of treatments on tumor volume, in addition to IGF-1 normalization. All evaluated treatments were included in an efficiency frontier. This addition has shown that radiotherapy and the impact on tumor volume are decisive in the management of second-line treatments for acromegaly. Indeed, radiotherapy enables patients to achieve complete remission, i.e. without the need for drug treatment. This is an important factor for patients, given that acromegaly treatments are chronic and usually lifelong. This study is an additional tool for treatment choice including both a clinical and economic perspective.