Integrative clinical, hormonal, and molecular data associate with invasiveness in acromegaly: REMAH study

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Abstract

Introduction: Growth hormone (GH)-secreting pituitary tumors (GHomas) are the most common acromegaly cause. At diagnosis, most of them are macroadenomas, and up to 56% display cavernous sinus invasion. Biomarker assessment associated with tumor growth and invasion is important to optimize their management. Objectives: The study aims to identify clinical/hormonal/molecular biomarkers associated with tumor size and invasiveness in GHomas and to analyze the influence of pre-treatment with somatostatin analogs (SSAs) or dopamine agonists (DAs) in key molecular biomarker expression. Methods: Clinical/analytical/radiological variables were evaluated in 192 patients from the REMAH study (ambispective multicenter post-surgery study of the Spanish Society of Endocrinology and Nutrition). The expression of somatostatin/ghrelin/dopamine system components and key pituitary/proliferation markers was evaluated in GHomas after the first surgery. Univariate/multivariate regression studies were performed to identify association between variables. Results: Eighty percent of patients harbor macroadenomas (63.8% with extrasellar growth). Associations between larger and more invasive GHomas with younger age, visual abnormalities, higher IGF1 levels, extrasellar/suprasellar growth, and/or cavernous sinus invasion were found. Higher GH1 and lower PRL/POMC/CGA/AVPR1B/DRD2T/DRD2L expression levels (P

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Sampedro-Nuñez, M., Herrera-Martínez, A. D., Ibáñez-Costa, A., Rivero-Cortes, E., Venegas, E., Robledo, M., … Luque, R. M. (2024). Integrative clinical, hormonal, and molecular data associate with invasiveness in acromegaly: REMAH study. European Journal of Endocrinology, 190(6), 421–433. https://doi.org/10.1093/ejendo/lvae045

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