Treatment with octreotide LAR in clinically non-functioning pituitary adenoma

Results from a case-control study

Alessandra Fusco, Antonella Giampietro, Antonio Bianchi, Vincenzo Cimino, Francesca Lugli, Serena Piacentini, Margherita Lorusso, Anna Tofani, Germano Perotti, Libero Lauriola, Carmelo Anile, Giulio Maira, Alfredo Pontecorvi, Laura De Marinis

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Surgical cure cannot be achieved in most patients with invasive non-functioning pituitary macroadenoma (NFPA). Short-term residual tumor treatment with somatostatin analogs has produced disappointing results. This prospective case-control study assessed the efficacy of chronic treatment with long acting octreotide (octreotide LAR) on tumor volume in patients harboring post-surgical NFPA residue. The study population comprised 39 patients with NFPAs not cured by surgery. All patients underwent somatostatin receptor scintigraphy at least 6 months after the last surgery. Patients with a positive pituitary level octreoscan at (n = 26) received octreotide LAR (20 mg every 28 days) for ≥12 months (mean follow-up 37 ± 18 months) (Treated group). Moreover, a fragment of tumor tissue from patients in the treated group was retrospectively collected to assess the immunohistochemical expression of somatostatin receptor subtypes (SSTRs). The patients with a negative octreoscan (n = 13) formed the control group (mean follow-up 37 ± 16 months). Hormonal, radiological and visual field parameters were periodically assessed. In the treated group, all tumors expressed at least one SSTR subtype. The SSTR5 subtype was the most abundant, followed by SSTR3. The tumor residue increased in five of 26 patients (19%) in the treated group and in seven of 13 controls (53%). Visual field and pituitary function did not change in any patient. This study indicates that SSTR5 and SSTR3 are the most frequently expressed SSTR subtypes in NFPAs and supports a potential role of SSTR subtypes in stabilization of tumor remnant from NFPAs.

Original languageEnglish
Pages (from-to)571-578
Number of pages8
JournalPituitary
Volume15
Issue number4
DOIs
Publication statusPublished - Dec 2012

Fingerprint

Octreotide
Pituitary Neoplasms
Case-Control Studies
Somatostatin Receptors
Therapeutics
Visual Fields
Neoplasms
Residual Neoplasm
Somatostatin
Tumor Burden
Radionuclide Imaging
Control Groups

Keywords

  • Octreoscan
  • Octreotide
  • Pituitary adenoma
  • Somatostatin receptors

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

Fusco, A., Giampietro, A., Bianchi, A., Cimino, V., Lugli, F., Piacentini, S., ... De Marinis, L. (2012). Treatment with octreotide LAR in clinically non-functioning pituitary adenoma: Results from a case-control study. Pituitary, 15(4), 571-578. https://doi.org/10.1007/s11102-011-0370-8

Treatment with octreotide LAR in clinically non-functioning pituitary adenoma : Results from a case-control study. / Fusco, Alessandra; Giampietro, Antonella; Bianchi, Antonio; Cimino, Vincenzo; Lugli, Francesca; Piacentini, Serena; Lorusso, Margherita; Tofani, Anna; Perotti, Germano; Lauriola, Libero; Anile, Carmelo; Maira, Giulio; Pontecorvi, Alfredo; De Marinis, Laura.

In: Pituitary, Vol. 15, No. 4, 12.2012, p. 571-578.

Research output: Contribution to journalArticle

Fusco, A, Giampietro, A, Bianchi, A, Cimino, V, Lugli, F, Piacentini, S, Lorusso, M, Tofani, A, Perotti, G, Lauriola, L, Anile, C, Maira, G, Pontecorvi, A & De Marinis, L 2012, 'Treatment with octreotide LAR in clinically non-functioning pituitary adenoma: Results from a case-control study', Pituitary, vol. 15, no. 4, pp. 571-578. https://doi.org/10.1007/s11102-011-0370-8
Fusco, Alessandra ; Giampietro, Antonella ; Bianchi, Antonio ; Cimino, Vincenzo ; Lugli, Francesca ; Piacentini, Serena ; Lorusso, Margherita ; Tofani, Anna ; Perotti, Germano ; Lauriola, Libero ; Anile, Carmelo ; Maira, Giulio ; Pontecorvi, Alfredo ; De Marinis, Laura. / Treatment with octreotide LAR in clinically non-functioning pituitary adenoma : Results from a case-control study. In: Pituitary. 2012 ; Vol. 15, No. 4. pp. 571-578.
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abstract = "Surgical cure cannot be achieved in most patients with invasive non-functioning pituitary macroadenoma (NFPA). Short-term residual tumor treatment with somatostatin analogs has produced disappointing results. This prospective case-control study assessed the efficacy of chronic treatment with long acting octreotide (octreotide LAR) on tumor volume in patients harboring post-surgical NFPA residue. The study population comprised 39 patients with NFPAs not cured by surgery. All patients underwent somatostatin receptor scintigraphy at least 6 months after the last surgery. Patients with a positive pituitary level octreoscan at (n = 26) received octreotide LAR (20 mg every 28 days) for ≥12 months (mean follow-up 37 ± 18 months) (Treated group). Moreover, a fragment of tumor tissue from patients in the treated group was retrospectively collected to assess the immunohistochemical expression of somatostatin receptor subtypes (SSTRs). The patients with a negative octreoscan (n = 13) formed the control group (mean follow-up 37 ± 16 months). Hormonal, radiological and visual field parameters were periodically assessed. In the treated group, all tumors expressed at least one SSTR subtype. The SSTR5 subtype was the most abundant, followed by SSTR3. The tumor residue increased in five of 26 patients (19{\%}) in the treated group and in seven of 13 controls (53{\%}). Visual field and pituitary function did not change in any patient. This study indicates that SSTR5 and SSTR3 are the most frequently expressed SSTR subtypes in NFPAs and supports a potential role of SSTR subtypes in stabilization of tumor remnant from NFPAs.",
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