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Deim Seminar


Treatment of acromegaly in the era of Precision medicine


Manuel Puig-Domingo

Professor/a organitzador/a

Domnec Savi Puig Valls


Hospital Germans Trias i Pujol, UAB, UCLA


09-07-2019 08:39


The need for precision medicine is driven by the heterogeneous nature of many diseases, and also this is the case of acromegaly. The current treatment algorithms for acromegaly are based upon a trial and error approach in which first generation somatostatin receptors ligands (SRL) are always the first-line medical therapy or as second-line therapy in patients undergoing unsuccessful surgery. However, because a high percentage of about 50% therapeutic failure, the inclusion of robust biomarkers identifying therapeutic response to SRL in the clinical guidelines is highly awaited. Such an approach would allow for a quicker achievement of disease control, better quality of life in the patient and would potentially cost-beneficial. At present, information coming from adenoma T2 MRI signal, octreotide GH suppression test and SSTR2, E-cadherine and Ki-67 immunohistochemistry among other biomarkers, has improved the capacity of predicting SRL response. The accumulated data on different markers analyzed by data mining is highly promising for including them in therapeutic algorithms, provided that large scale assays may validate prospectively this approach. The validation trials will contribute to establish the standardization of measurement of the different biomarkers and hopefully will allow also to define cut-off values, a crucial step for final application to the clinical practice in the therapeutic-decision process. Short CV Manuel Puig-Domingo, Scientific Director of the IGTP. Dr Puig graduated in medicine in 1988 at the Autonomous University of Barcelona and undertook his residency at the Endocrinology and Nutrition Service at the Sant Pau Hospital (Barcelona). He spent two years as a researcher at the University of Texas Health Science Center before returning to Sant Pau as a researcher and practicing doctor, where he was Coordinator of the Experimental Endocrinology Laboratory. He has been Medical Director of the Maresme Health Consortium, Scientific Director of the Hospital at Matar and Vice President of the Catalan and Spanish Societies of Endocrinology and Nutrition.


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