Pasireotide-LAR and pegvisomant combination in resistant acromegaly: a case series of predominantly mammosomatotroph adenomas
Authors' conclusion
In this series of predominantly mammosomatotroph adenomas in younger adults, combination PAS plus PEGV offers potential durable biochemical control, tumor stability and PEGV dose reduction in treatment-resistant acromegaly.
Study context
- Population
- Patients with treatment-resistant acromegaly (somatotroph n = 2 or mammosomatotroph n = 4 macroadenomas; 5 females, 1 male; age 15 to 44 years) without disease control post-surgery despite multiple lines of medical therapy
- Participants
- 6 patients
- Outcome
- Tumor stability and IGF-1 normalisation
- Follow-up
- Median 3.3 years (range 0.5 to 5.9)
Methodological detailssingle-centre, tertiary pituitary center
- Single-centre
- Tertiary pituitary center
Main finding
As reported in the abstract
Maintained tumor stability and achieved normal IGF-1
6 of 6
Biochemical escape after 9 months of biochemical control, requiring 2nd surgery and radiosurgery
1
Observational data: associations, not effects.
Safety
- Discontinued pegvisomant (PEGV) after 3 years due to injection site pain
- 1 patient
- Hyperglycemia in the pre-diabetes range
- 3 patients
- No hepatotoxicity, acute symptomatic biliary disease, or arrhythmias occurred
Original publication
Pasireotide-LAR and pegvisomant combination in resistant acromegaly: a case series of predominantly mammosomatotroph adenomas. Pituitary. Published 23 September 2026. doi:10.
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