Revisiting the usefulness of the short acute octreotide test to predict treatment outcomes in acromegaly

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...

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Autores: Marqués Pamies, Montserrat|||0000-0001-6391-5070, Gil Ortega, Joan|||0000-0003-1030-9119, Valassi, Elena|||0000-0002-3864-0105, Hernández García, Marta|||0000-0003-1237-298X, Biagetti, Betina|||0000-0002-8837-4343, Giménez-Palop, Olga|||0000-0002-4526-6342, Martínez, Silvia, Carrato, Cristina|||0000-0002-1953-8287, Pons, Laura|||0000-0003-0784-4110, Villar-Taibo, Rocío, Araujo-Castro, Marta|||0000-0002-0519-0072, Blanco, Concepción, Simón, Inmaculada, Simó-Servat, Andreu|||0000-0002-1092-1327, Xifra, Gemma, Vázquez, Federico|||0000-0001-6493-2374, Pavón, Isabel, García-Centeno, Rogelio, Zavala, Roxana, Hanzu, Felicia A.|||0000-0002-2399-4023, Mora, Mireia|||0000-0002-5887-5016, Aulinas, Anna|||0000-0002-1205-7114, Vilarrasa, Nuria|||0000-0003-3188-1990, Librizzi, Soledad, Calatayud, María|||0000-0002-6737-7289, de Miguel, Paz, Alvarez-Escola, Cristina, Picó Alfonso, Antonio M.|||0000-0002-7549-7563, Sampedro, Miguel, Salinas, Isabel, Fajardo-Montañana, Carmen|||0000-0002-0784-0761, Cámara, Rosa|||0000-0002-3289-3400, Bernabeu Morón, Ignacio|||0000-0001-8421-7394, Jordà, Mireia|||0000-0003-3709-1850, Webb, S. M.|||0000-0001-7052-6436, Marazuela, Mónica|||0000-0003-1158-9618, Puig Domingo, Manuel|||0000-0002-6744-7195
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:290180
Acceso en línea:https://ddd.uab.cat/record/290180
https://dx.doi.org/urn:doi:10.3389/fendo.2023.1269787
Access Level:acceso abierto
Palabra clave:Acromegaly
Acute octreotide test
Individualized treatment
Precision medicine
Prediction
Somatostatin analogs
Descripción
Sumario: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). 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 (GH) 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. In all, 30 patients were responders and 17 were non-responders. GH 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 = 1.4ng/mL showed the highest ability to identify responders (accuracy of 81%, sensitivity of 73.3%, and specificity of 94.1%). GH = 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 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). 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.

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