Loss of efficacy of pasireotide after its re-administration: is there a reason why?

Rare Tumors

Lemonia Mathiopoulou¹  Stylianos Mandanas¹  Alexandra Chrisoulidou¹  Maria Boudina¹  Kalliopi Pazaitou-Panayiotou¹ 

[1] Department of Endocrinology, Theagenio Cancer Hospital, Thessaloniki

关键词: Cushing's disease;    pasireotide;    somatostatin analog;    resistance;    remission;   

DOI  :  10.4081/rt.2016.6489

来源: PAGEPress Publications

【 摘 要 】

Pasireotide is a recently approved medical treatment for persistent or recurrent Cushing’s disease (CD). However, an escape from the initial successful response has not yet been described. A 42-year-old female presented with several symptoms indicative of hypercortisolism. Biochemical evaluation and imaging were consistent with CD due to a pituitary adenoma. Surgical excision of the adenoma was unsuccessful and gamma-knife radiosurgery was followed. Our patient remained hypercortisolemic thus treatment with pasireotide (900 ug subcutaneously twice daily) was decided. Biochemical and clinical remission was noted shortly thereafter. Moderate adverse events led to dose reduction to 600 ug subcutaneously twice daily. The patient remained in remission for 6 months, when treatment was discontinued due to cholecystitis. One month after cholecystectomy, pasireotide was restarted with no clinical or biochemical benefit that time. Pasireotide is an effective medical treatment for CD. Nevertheless, a loss of its initial efficacy may rarely be described.

【 授权许可】

Unknown