The following is a summary of “Multibiomarker Acro-TIME Score Predicts fg-SRLs Response: Preliminary Results of a Retrospective Acromegaly Cohort,” published in the May 2024 issue of Endocrinology by Chiloiro, et al.
Prompt control of acromegaly is crucial to mitigate associated morbidity and mortality. First-generation somatostatin receptor ligands (fg-SRLs) serve as primary medical therapy, yet a notable subset of patients shows an inadequate response. While several predictors of fg-SRL response have been identified, a comprehensive prognostic model still needs to be discovered. For a study, researchers sought to develop a prognostic model integrating clinical, biochemical, pathological, and radiological parameters, including insights into the immune tumor microenvironment, to predict response to fg-SRL therapy in patients with acromegaly.
A retrospective, single-center cohort study enrolled 67 treatment-naïve patients with acromegaly. Fifteen clinical, pathological, and radiological features were assessed as independent risk factors for fg-SRL response using univariable and multivariable logistic regression analyses. A stepwise selection method identified the final regression model, from which a nomogram was derived.
Of the cohort, 37 patients responded to fg-SRLs. Elevated risk for poor fg-SRL response was associated with somatotropinomas exhibiting absent/cytoplasmic SSTR2 expression (OR 5.493, 95% CI 1.19-25.16, P = .028), low CD68+/CD8+ ratio (OR 1.162, 95% CI 1.01-1.33, P = .032), and lack of radical surgical resection (OR 0.106, 95% CI 0.025-0.447, P = .002). The nomogram derived from the stepwise regression model, incorporating CD68+/CD8+ ratio, SSTR2 score, and postsurgery residual tumor, demonstrated strong predictive accuracy for fg-SRL response (area under the curve 0.85).
While requiring prospective validation, the predictive nomogram presents a practical tool for the early prognosis of fg-SRL therapy outcomes in patients with acromegaly.
Reference: academic.oup.com/jcem/article-abstract/109/5/1341/7425418
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