PMID-22574156 – Meta-Analysis Octreotide Tumor Mass in Acromegaly
Giustina A, Mazziotti G, Torri V, Spinello M, Floriani I, Melmed S. Meta-analysis on the effects of octreotide on tumor mass in acromegaly. PLoS One. 2012;7(5):e36411.
Quick Reference
| Property | Value |
|---|---|
| PMID | 22574156 |
| DOI | 10.1371/journal.pone.0036411 |
| Year | 2012 |
| Journal | PLoS One |
| Study Type | Meta-analysis |
| Evidence Level | I |
| Sample | 921 patients across 34 studies |
| Peptide(s) Studied | Octreotide |
Key Findings
- Clinically relevant tumor shrinkage (>=20% reduction) occurred in 56.8% of patients treated with octreotide LAR as primary therapy
- Presurgical octreotide LAR induced clinically relevant tumor shrinkage in 50.5% of patients
- Mean tumor volume reduction was -38.3% in primary therapy studies
- Macroadenomas showed greater absolute volume reduction than microadenomas
- The pooled analysis confirmed that octreotide LAR has a significant antiproliferative effect on GH-secreting pituitary adenomas beyond hormonal control alone
Study Design
Systematic literature search and meta-analysis of 34 published studies evaluating the effect of octreotide LAR on pituitary tumor size in acromegaly patients. Studies included both primary therapy and presurgical treatment protocols. Random-effects models were used to pool estimates of tumor shrinkage rates.
Limitations
- Significant heterogeneity across included studies in terms of patient selection, octreotide dosing, and duration of treatment
- Definitions of "clinically relevant" tumor shrinkage varied among studies
- Publication bias may have favored studies with positive results
- Most included studies were observational or open-label; few were RCTs
Clinical Relevance
This meta-analysis provides the strongest aggregate evidence that octreotide LAR has antiproliferative properties beyond its antisecretory effects. The finding that over half of patients experience clinically relevant tumor shrinkage supports the use of octreotide LAR as primary medical therapy in selected acromegaly patients, particularly those with large macroadenomas where surgical cure is unlikely.
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#research #meta-analysis #octreotide #evidence-level-I