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

2023; Frontiers Media; Volume: 14; Linguagem: Inglês

10.3389/fendo.2023.1269787

1664-2392

Montserrat Marqués-Pamies, Joan Gil, Elena Valassi, Marta Hernández, Betina Biagetti, Olga Giménez‐Palop, Silvia Martínez, Cristina Carrato, Laura Pons, Rocío Villar-Taibo, Marta Araujo‐Castro, Concepción Blanco, I Simón, Andreu Simó-Servat, Gemma Xifra, Federico Vázquez, Isabel Pavón, Rogelio García-Centeno, Roxana Zavala, Felicia A. Hanzu, Mireia Mora, Anna Aulinas, Núria Vilarrasa, Soledad Librizzi, María Calatayud, Paz de Miguel, Cristina Álvarez‐Escolá, Antonio Picó, Miguel Sampedro, Isabel Salinas, Carmen Fajardo, Rosa Cámara, Ignacio Bernabéu, Mireia Jordà, Susan M. Webb, Mónica Marazuela, Manel Puig‐Domingo,

Adrenal and Paraganglionic Tumors

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 (GH 2h ) 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.