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Personalized Medicine in Acromegaly: The ACROFAST Study

Marques-Pamies, Montserrat, Gil, Joan, Sampedro-Nuñez, Miguel, Valassi, Elena, Biagetti, Betina, Giménez-Palop, Olga, Hernández, Marta, Martínez, Silvia, Carrato, Cristina, Villar-Taibo, Rocío, Araujo-Castro, Marta, Blanco, Concepción, Simón-Muela, Inmaculada, Simó-Servat, Andreu, Xifra, Gemma, Vázquez, Federico, Pavón, Isabel, Rosado, José Antonio, García-Centeno, Rogelio, Zavala, Roxana, Hanzu, Felicia Alexandra, Mora, Mireia, Aulinas, Anna, Vilarrasa, Nuria, Librizzi, Soledad, Calatayud, María, de Miguel, Paz, Alvarez-Escola, Cristina, Picó, Antonio, Salinas, Isabel, Fajardo-Montañana, Carmen, Cámara, Rosa, Bernabéu, Ignacio, Jordà, Mireia, Webb, Susan M, Marazuela, Mónica, Puig-Domingo, Manel·2024·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/clinem/dgae444
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Abstract

Context: Medical treatment of acromegaly is currently performed through a trial-and-error approach using first-generation somatostatin receptor ligands (fgSRLs) as first-line drugs, with an effectiveness of about 50%, and subsequent drugs are indicated through clinical judgment. Some biomarkers can predict fgSRLs response. Objective: Here we report the results of the ACROFAST study, a clinical trial in which a protocol based on predictive biomarkers of fgSRLs was evaluated. Methods: This was a prospective trial (21 university hospitals) comparing the effectiveness and time-to-control of 2 treatment protocols during 12 months: (A) a personalized protocol in which the first options were fgSRLs as monotherapy or in combination with pegvisomant, or pegvisomant as monotherapy depending on the short acute octreotide test (sAOT) results, tumor T2 magnetic resonance (MRI) signal or immunostaining for E-cadherin; and (B) a control group with treatment always started by fgSRLs and the other drugs included after demonstrating inadequate control. Results: Eighty-five patients participated; 45 in the personalized and 40 in the control group. More patients in the personalized protocol achieved hormonal control compared to those in the control group (78% vs 53%, P < .05). Survival analysis revealed a hazard ratio for achieving hormonal control adjusted by age and sex of 2.53 (CI, 1.30-4.80). Patients from the personalized arm were controlled in a shorter period of time (P = .01). Conclusion: Personalized medicine is feasible using a relatively simple protocol, and it allows a higher number of patients to achieve control in a shorter period of time.

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Cited by 30

Research works printed but not linked: 45

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Metadata

Authors
Marques-Pamies, M., Gil, J., Sampedro-Nuñez, M., Valassi, E., Biagetti, B., Giménez-Palop, O., Hernández, M., Martínez, S., Carrato, C., Villar-Taibo, R., Araujo-Castro, M., Blanco, C., Simón-Muela, I., Simó-Servat, A., Xifra, G., Vázquez, F., Pavón, I., Rosado, J. A., García-Centeno, R., Zavala, R., Hanzu, F. A., Mora, M., Aulinas, A., Vilarrasa, N., Librizzi, S., Calatayud, M., de Miguel, P., Alvarez-Escola, C., Picó, A., Salinas, I., Fajardo-Montañana, C., Cámara, R., Bernabéu, I., Jordà, M., Webb, S. M., Marazuela, M., & Puig-Domingo, M.
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
2024-06-29
Volume
110
Issue
1
Pages
30-40
ISSN
  • 0021-972X
  • 1945-7197
DOI
10.1210/clinem/dgae444
Cited by
30
Language
en
Licence
creativecommons.org/licenses/by/4.0/ (vor)
Funders
  • Instituto de Salud Carlos III (PMP15/00027)
  • European Union-ERDF (PMP22/00021)

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CoChat. (2026). Citation check: Personalized Medicine in Acromegaly: The ACROFAST Study. https://app.cochat.ai/papers/10.1210/clinem/dgae444
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Marques-Pamies, M., Gil, J., Sampedro-Nuñez, M., Valassi, E., Biagetti, B., Giménez-Palop, O., Hernández, M., Martínez, S., Carrato, C., Villar-Taibo, R., Araujo-Castro, M., Blanco, C., Simón-Muela, I., Simó-Servat, A., Xifra, G., Vázquez, F., Pavón, I., Rosado, J. A., García-Centeno, R., . . . Puig-Domingo, M. (2024). Personalized Medicine in Acromegaly: The ACROFAST Study. The Journal of Clinical Endocrinology & Metabolism. https://doi.org/10.1210/clinem/dgae444

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