Using a precision approach to optimize the drug therapy of patients with acromegaly syndrome

Abstract

Modern problems of acromegaly treatment are associated with the heterogeneous composition of somatotrophic tumors, differing in clinical course and sensitivity to the proposed therapy. Under these conditions, the achievement of acromegaly control depends on the stratification of clinical, laboratory and instrumental data in order to identify significant biomarkers that allow predicting the receptor phenotype and biological behavior of the tumor, the tendency to relapse and the long-term effectiveness of drug therapy. The review discusses modern predictor models reflecting the radicality of surgical treatment, the risk of the continued growth of a resident tumor, the long-term results of clinical use of first-generation somatostatin receptor ligands (fg-SRLs), as well as the possibilities of therapeutic maneuver. It is proposed to use pharmacotherapeutic testing to evaluate the receptor expression of tumor cells and predict the effectiveness of long-term treatment of fg-SRLs. Summary data characterizing various morphotypes of somatotrophic tumors are presented. It is shown that the use of a precision approach can significantly accelerate the time to achieve control and improve the quality of the treatment aid in patients with acromegaly syndrome.