Approach to the Patient With Treatment-resistant Acromegaly

Eva C. Coopmans, Aart J. Van Der Lely, Sebastian J.C.M.M. Neggers

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)

Abstract

Although most tumors in patients with acromegaly are benign and are cured or controlled by surgery and/or first-generation somatostatin receptor ligands therapy, some can behave more aggressively and are resistant to these standard therapies. Acromegaly, if left untreated, is a rare and chronic disorder, commonly caused by a GH-producing pituitary adenoma and is associated with significant comorbidities and an increased mortality. Transsphenoidal surgery is considered the mainstay of acromegaly management, but medical therapy has an increasingly important role. However, disease activity is not fully controlled in a significant number of patients treated with surgery and/or high-dose first-generation somatostatin receptor ligand monotherapy. In these circumstances, therefore, repeated surgery, second-line medical therapy, and radiotherapy, alone or combined as multimodal therapeutic strategies should be considered, in a patient-centered perspective.

Original languageEnglish
Pages (from-to)1759-1766
Number of pages8
JournalJournal of Clinical Endocrinology and Metabolism
Volume107
Issue number6
DOIs
Publication statusPublished - 17 May 2022
Externally publishedYes

Keywords

  • acromegaly
  • clinical case
  • medical treatment
  • pasireotide
  • pegvisomant
  • pituitary
  • somatostatin analogs
  • surgery and radiotherapy
  • Humans
  • Pituitary Neoplasms/complications
  • Acromegaly/drug therapy
  • Human Growth Hormone/therapeutic use
  • Receptors, Somatostatin
  • Somatostatin

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