Lanreotide 60 mg, a longer-acting somatostatin analog: Tumor shrinkage and hormonal normalization in acromegaly

被引:21
作者
Cozzi R. [1 ,2 ]
Barausse M. [1 ,2 ]
Sberna M. [3 ]
Lodrini A. [4 ]
Franzini A. [4 ]
Lasio G. [4 ]
Attanasio R. [1 ,2 ]
机构
[1] Division of Endocrinology, Niguarda Hospital
[2] Division of Endocrinology, Niguarda Hospital
[3] Division of Neuroradiology, Niguarda Hospital
[4] Division of Neurosurgery, Neurologic Institute Carlo Besta, Milan
关键词
Acromegaly; GH; IGF-I; Lanreotide; Somatostatin analogs; Tumor shrinkage;
D O I
10.1023/A:1012832230598
中图分类号
学科分类号
摘要
Background: Somatostatin analogues are nowadays the milestone in the medical treatment of acromegaly. We evaluated the effects of a new 60 mg longer-acting formulation of lanreotide (LAN60) on GH/IGF-I levels and tumor size. Patients: Twenty-one acromegalics entered a prospective monocentric open study. Eight were consecutive "de novo" patients (group I). Thirteen patients sensitive to SA (GH levels < 2.5 μg/l and/or IGF-I normalization on chronic LAN 30 mg (LAN30) treatment) were switched to LAN60 (group II). Protocol: LAN60 was administered IM for 6 cycles at 28 day intervals. In group I when GH/IGF-I remained pathological, the intervals were shortened to 21 days for the last three cycles. Controls: GH/IGF-I at the end of the 1st, 3rd and 6th cycle; MRI at the end of the study in all patients in group I bearing an adenoma. Results: Group I.GH (p = 0.00638, below 2.5 μg/l in two patients) and IGF-I (p = 0.0289, normalized in 5) significantly decreased. In one of two patients shortening the LAN60 schedule was more effective in suppressing GH/IGF-I. Group II. No change in GH and IGF-I levels was observed with the administration of LAN60, instead of LAN30. On LAN60 GH remained below 2.5 μg/l in 8/10 patients and IGF-I normal in 11/11 patients that had attained those values on LAN30. Tumor markedly shrank (23% to 64% vs basal), from 1400 (664-1680) mm3 to 520 (500-960) mm3 (median, interquartile, p = 0.0218) in all the 5 evaluable patients. Conclusion: LAN60 is a very effective and longer-lasting formulation for the treatment of acromegaly. A closer administration schedule might achieve greater efficacy. Its effectiveness in shrinking tumor opens new perspectives in the therapy of acromegaly.
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页码:231 / 238
页数:7
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共 26 条
  • [1] Bauer W., Briner U., Doepfner W., Haller R., Huguenin R., Marbach P., Petcher T.J., Pless W., SMS 201-995: A very potent and selective octapeptide analogue of somatostatin with prolonged action, Life Sci, 3, pp. 1133-1140, (1982)
  • [2] Greenman Y., Melmed S., Heterogeneous expression of two somatostatin receptor subtypes in pituitary tumors, J Clin Endocrinol Metab, 78, pp. 398-403, (1994)
  • [3] Sassolas G., Khalfallah Y., Chayvialle J.A., Cohen R., Merabet S., Casez J.P., Calvet P., Cabrera P., Effects of the somatostatin analog BIM 23014 on the secretion of growth hormone, thyrotropin, and digestive peptides in normal men, J Clin Endocrinol Metab, 68, pp. 239-246, (1989)
  • [4] Heron I., Thomas F., Dero M., Poutrain J., Henane S., Catus F., Kuhn J.M., Treatment of acromegaly with sustained-release lanreotide, a new somatostatin analog, Presse Med, 22, pp. 526-531, (1993)
  • [5] Stewart P.M., Kane K.F., Stewart S.E., Lancranjan I., Sheppard M.C., Depot long-acting somatostatin analog (Sandostatin LAR) is an effective treatment for acromegaly, J Clin Endocrinol Metab, 80, pp. 3267-3272, (1995)
  • [6] Melmed S., Jackson I., Kleinberg D., Klibanski A., Current treatment guidelines for acromegaly, J Clin Endocrinol Metab, 83, pp. 2646-2652, (1998)
  • [7] Robbins R.J., Depot somatostatin analogs-A new first line therapy for acromegaly, J Clin Endocrinol Metab, 82, pp. 15-17, (1998)
  • [8] Lancranjan J., Bruns C., Grass P., Jacquet P., Jervell J., Kendall-Taylor P., Lamberts S.W.J., Marbach P., Orskov H., Pagani G., Sheppard M., Simionescu L., Sandostatin-LAR: A promising therapeutic tool in the management of acromegalic patients, Metabolism, 45, pp. 67-71, (1996)
  • [9] Johnson M.R., Chowdrey H.S., Thomas F., Grint C., Lightman S.L., Pharmacokinetics and efficacy of the long-acting somatostatin analogue somatuline in acromegaly, Eur J Endocrinol, 130, pp. 229-234, (1994)
  • [10] Morange I., De Boisvilliers F., Chanson P., Lucas B., DeWailly D., Catus F., Thomas F., Jaquet P., Slow release lanreotide treatment in acromegalic patients previously normalized by octreotide, J Clin Endocrinol Metab, 79, pp. 145-151, (1994)