Frontiers in Endocrinology (Oct 2023)

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

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

DOI
https://doi.org/10.3389/fendo.2023.1269787
Journal volume & issue
Vol. 14

Abstract

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IntroductionWe 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) .MethodsA 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 (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.ResultsIn 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).ConclusionThe 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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