pasireotide and Endocrine-Gland-Neoplasms

The delay in controlling the disease in patients who do not respond to first-line treatment with first generation somatostatin receptor ligands (first-generation SRLs) can be quantified in years, as every modification in the medical therapy requires some months to be fully evaluated. Considering this, acromegaly treatment should benefit from personalized medicine therapeutic approach by using biomarkers identifying drug response. Pasireotide has been positioned mostly as a compound to be used in first-generation SRLs resistant patients and after surgical failure, but sufficient data are now available to indicate it is a first line therapy for patients with certain characteristics. Pasireotide has been proved to be useful in patients in which hyperintensity T2 MRI signal is shown and in those depicting low

Topics: Acromegaly; Adenoma; Algorithms; Biomarkers; Endocrine Gland Neoplasms; Genetic Markers; Growth Hormone-Secreting Pituitary Adenoma; Humans; Image Processing, Computer-Assisted; Insulin-Like Growth Factor I; Ligands; Machine Learning; Magnetic Resonance Imaging; Models, Genetic; Octreotide; Phosphorylation; Precision Medicine; Receptors, Somatostatin; Somatostatin; Treatment Outcome

Recent discoveries in molecular biology offer new perspectives in the treatment of endocrine tumors. There is currently no medical therapy for Cushing's disease that targets the pituitary adenoma. Pasireotide, a new somatostatin analog, demonstrates a strong affinity for somatostatin receptors expressed by corticotroph adenomas. Some recent clinical trials showed a decrease of urinary free cortisol with pasireotide. This new treatment could be useful in case of pituitary surgery failure. Thyroid tumorigenesis involves kinase signaling cascade. Tyrosine-kinase inhibitors have now been tested in the treatment of progressive differentiated iodine refractory thyroid carcinomas or medullary carcinomas and showed modestly encouraging results.

Topics: ACTH-Secreting Pituitary Adenoma; Adenoma; Benzenesulfonates; Carcinoma; Carcinoma, Medullary; Clinical Trials as Topic; Endocrine Gland Neoplasms; Endocrinology; Humans; Niacinamide; Phenylurea Compounds; Pituitary ACTH Hypersecretion; Protein Kinase Inhibitors; Protein-Tyrosine Kinases; Pyridines; Receptors, Somatostatin; Somatostatin; Sorafenib; Thyroid Neoplasms; Treatment Outcome