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      In vitro impact of pegvisomant on growth hormone-secreting pituitary adenoma cells

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          Abstract

          Pegvisomant (PEG), an antagonist of growth hormone (GH)-receptor (GHR), normalizes insulin-like growth factor 1 (IGF1) oversecretion in most acromegalic patients unresponsive to somatostatin analogs (SSAs) and/or uncontrolled by transsphenoidal surgery. The residual GH-secreting tumor is therefore exposed to the action of circulating PEG. However, the biological effect of PEG at the pituitary level remains unknown. To assess the impact of PEG in vitro on the hormonal secretion (GH and prolactin (PRL)), proliferation and cellular viability of eight human GH-secreting tumors in primary cultures and of the rat somatolactotroph cell line GH4C1. We found that the mRNA expression levels of GHR were characterized in 31 human GH-secreting adenomas (0.086 copy/copy β-Gus) and the GHR was identified by immunocytochemistry staining. In 5/8 adenomas, a dose-dependent inhibition of GH secretion was observed under PEG with a maximum of 38.2±17% at 1μg/mL ( P<0.0001 vs control). A dose-dependent inhibition of PRL secretion occurred in three mixed GH/PRL adenomas under PEG with a maximum of 52.8±11.5% at 10μg/mL ( P<0.0001 vs control). No impact on proliferation of either human primary tumors or GH4C1 cell line was observed. We conclude that PEG inhibits the secretion of GH and PRL in primary cultures of human GH(/PRL)-secreting pituitary adenomas without effect on cell viability or cell proliferation.

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          Most cited references44

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          Acromegaly: an endocrine society clinical practice guideline.

          The aim was to formulate clinical practice guidelines for acromegaly.
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            Expert consensus document: A consensus on the medical treatment of acromegaly.

            In March 2013, the Acromegaly Consensus Group met to revise and update guidelines for the medical treatment of acromegaly. The meeting comprised experts skilled in the medical management of acromegaly. The group considered treatment goals covering biochemical, clinical and tumour volume outcomes, and the place in guidelines of somatostatin receptor ligands, growth hormone receptor antagonists and dopamine agonists, and alternative modalities for treatment including combination therapy and novel treatments. This document represents the conclusions of the workshop consensus.
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              Acromegaly Clinical Trial Methodology Impact on Reported Biochemical Efficacy Rates of Somatostatin Receptor Ligand Treatments: A Meta-Analysis

              Introduction: Biochemical efficacy of somatostatin receptor ligand (SRL) treatment in acromegaly is defined by metrics for GH and IGF-1 control. Since the earliest therapeutic trials, biochemical control criteria, medical formulations, and assay techniques have evolved. Materials and Methods: We searched PubMed for English-language trials published from 1974 to 2012 evaluating 10 or more patients, with a duration of more than 3 months and biochemical control as a key objective. We used a random-effects model to compare biochemical outcomes for octreotide and lanreotide trials according to study design characteristics. Results: A total of 4464 patients were enrolled in the analyzed trials; 4125 were treated, and 3787 completed study treatment. Overall achieved control rates were 56% for mean GH and 55% for IGF-1 normalization. Treatment duration was significantly related to both GH (P < .001) and IGF-1 control (P = .02). Prior SRL therapy (P = .01), and year of study publication (P = .03) were related to biochemical control for GH but not IGF-1. No statistically significant differences in GH or IGF-1 response rates were observed for multicenter vs single center, retrospective vs prospective, study drug, and preselection for SRL responsiveness. Dosing scheme, GH response criterion, or switch study design were also not statistically significant in determining GH or IGF-1 response rate. Conclusions: Clinical design characteristics anticipated to impart efficacy bias including switching, preselection for SRL responsiveness, and retrospective design had no statistically significant impact on efficacy determination. Later year of publication, study duration, and prior SRL use are significant efficacy determinants for acromegaly trial outcomes.
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                Author and article information

                Journal
                Endocr Relat Cancer
                Endocr. Relat. Cancer
                ERC
                Endocrine-Related Cancer
                Bioscientifica Ltd (Bristol )
                1351-0088
                1479-6821
                July 2016
                01 July 2016
                : 23
                : 7
                : 509-519
                Affiliations
                [1 ]Aix-Marseille University CNRS, CRN2M UMR7286, Marseille, France
                [2 ]Endocrine Research Unit Medizinische Klinik und Poliklinik IV, Klinikum der LMU, Munich, Germany
                [3 ]APHM Timone Department of Neurosurgery, Marseille, France
                [4 ]APHM Conception, Laboratory of Molecular Biology, Marseille, France
                [5 ]Department of Endocrinology Max Planck Institute of Psychiatry, Munich, Germany
                [6 ]APHM Timone Laboratory of Neuropathology and Aix-Marseille University, INSERM, CRO2 UMR911, Marseille, France
                [7 ]APHM Conception Department of Endocrinology, Marseille, France
                Author notes
                Correspondence should be addressed to A Barlier; Email: anne.barlier@ 123456univ-amu.fr
                [*]

                (T Brue and A Barlier contributed equally to this work)

                Article
                ERC160140
                10.1530/ERC-16-0140
                5064756
                27267119
                2d90aba9-0268-4fc0-8a56-1354e53f8871
                © 2016 Society for Endocrinology

                This work is licensed under a Creative Commons Attribution 3.0 Unported License

                History
                : 1 June 2016
                : 3 June 2016
                Categories
                Research

                Oncology & Radiotherapy
                acromegaly,pegvisomant,prolactin,gh4c1,pituitary adenoma
                Oncology & Radiotherapy
                acromegaly, pegvisomant, prolactin, gh4c1, pituitary adenoma

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