Long-term treatment of somatostatin analog-refractory growth hormone-secreting pituitary tumors with pegvisomant alone or combined with long-acting somatostatin analogs: a retrospective analysis of clinical practice and outcomes

被引：37

作者：

Bianchi, Antonio ^{[1
]}

Valentini, Ferdinando ^{[2
]}

Iuorio, Raffaella ^{[3
]}

Poggi, Maurizio ^{[4
]}

Baldelli, Roberto ^{[5
]}

Passeri, Marina ^{[6
]}

Giampietro, Antonella ^{[1
]}

Tartaglione, Linda ^{[1
]}

Chiloiro, Sabrina ^{[1
]}

Appetecchia, Marialuisa ^{[5
]}

Gargiulo, Patrizia ^{[3
]}

Fabbri, Andrea ^{[6
]}

Toscano, Vincenzo ^{[4
]}

Pontecorvi, Alfredo ^{[1
]}

De Marinis, Laura ^{[1
]}

机构：

[1] Univ Cattolica Sacro Cuore, Sch Med, Dept Endocrinol, I-00168 Rome, Italy

[2] San Camillo Forlanini Hosp, Endocrinol Sect, I-00151 Rome, Italy

[3] Univ Roma La Sapienza, Endocrinol Sect, I-00185 Rome, Italy

[4] Univ Roma La Sapienza, Endocrinol Sect, St Andrea Hosp, Fac 2, I-00189 Rome, Italy

[5] Regina Elena Canc Inst IFO, Endocrinol Unit, I-00144 Rome, Italy

[6] Univ Roma Tor Vergata, St Eugenio & CTO Andrea Alesini Hosp, Endocrinol Unit, I-00145 Rome, Italy

来源：

JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH | 2013年 / 32卷

关键词：

RECEPTOR ANTAGONIST PEGVISOMANT; PREVIOUS RADIOTHERAPY; ACROMEGALIC PATIENTS; DISEASE-ACTIVITY; FACTOR-I; GH; COMBINATION; THERAPY; SAFETY; MULTICENTER;

D O I：

10.1186/1756-9966-32-40

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Pegvisomant (PEGV) is widely used, alone or with somatostatin analogs (SSA), for GH-secreting pituitary tumors poorly controlled by SSAs alone. No information is available on specific indications for or relative efficacies of PEGV + SSA versus PEGV monotherapy. Aim of our study was to characterize real-life clinical use of PEGV vs. PEGV + SSA for SSA-resistant acromegaly (patient selection, long-term outcomes, adverse event rates, doses required to achieve control). Methods: A retrospective analysis of data collected in 2005-2010 in five hospital-based endocrinology centers in Rome was performed. Sixty-two adult acromegaly patients treated >= 6 months with PEGV (Group 1, n = 35) or PEGV + SSA (Group 2, n = 27) after unsuccessful maximal-dose SSA monotherapy (>= 12 months) were enroled. Groups were compared in terms of clinical/biochemical characteristics at diagnosis and before PEGV or PEGV + SSA was started (baseline) and end-of-follow-up outcomes (IGF-I levels, adverse event rates, final PEGV doses). Results: Group 2 showed higher IGF-I and GH levels and sleep apnea rates, higher rates residual tumor tissue at baseline, more substantial responses to SSA monotherapy and worse outcomes (IGF-I normalization rates, final IGF-I levels). Tumor growth and hepatotoxicity events were rare in both groups. Final daily PEGV doses were similar and significantly increased with treatment duration in both groups. Conclusions: PEGV and PEGV + SSA are safe, effective solutions for managing SSA-refractory acromegaly. PEGV + SSA tends to be used for more aggressive disease associated with detectable tumor tissue. With both regimens, ongoing monitoring of responses is important since PEGV doses needed to maintain IGF-I control are likely to increase over time.

引用

页数：11