New molecular markers of response to medical therapy in acromegaly.

Aina Raventós, Joan Gil, Montserrat Marques-Pamies, Paula de Pedro-Campos, Carmín Puente de la Vega, Antonio Picó, Cristina Lamas, Elías Delgado, Edelmiro Menéndez, Guillermo Serra, Ignacio Bernabéu, Rocio Villar, Jordi Ferri, Karla Mariaca, Rebeca Martínez, Mónica Marazuela, Marta Araujo-Castro, Betina Biagetti, Mireia Jordà, Elena Valassi, Manel Puig-Domingo

Journal: Vitamins and hormones 2026;131():265-292

PMID: 41912297

Full Text on Elsevier Science View on PubMed

Abstract

The management of pituitary neuroendocrine tumors (PitNETs) is shifting toward a personalized medicine approach, supported by the identification of biomarkers that can guide individualized surgical and medical strategies. In acromegaly, medical therapy with somatostatin receptor ligands (SRLs), dopamine agonists, and GH receptor antagonists represent the cornerstone of treatment in patients with persistent disease after surgery or when surgery cannot be performed. However, therapeutic outcomes are highly variable, reflecting the substantial heterogeneity of somatotropinomas. The classical approach, which considers clinical factors, radiological features, and histological subtypes, continues to play a role but remains insufficient to reliably identify treatment response with high accuracy. New approaches such as those based on functional testing and omics sciences-including genomics, epigenomics, transcriptomics, and proteomics-are showing superiority in identifying determinants of treatment response. Although current evidence is growing, these approaches are still considered in the research field but are slowly being introduced in clinical practice. In this chapter, we review the available molecular and functional markers of response to medical therapy in acromegaly and discuss how to include them in the clinical ground for advancing precision medicine in this disease.

Address: Service of Endocrinology and Nutrition, Hospital Moisès Broggi, Sant Joan Despí, Barcelona, Spain; Endocrine Research Unit, Germans Trias i Pujol Research Institute (IGTP) and Service of Endocrinology and Nutrition, Hospital Universitari Germans Trias i Pujol, Badalona, Spain. Electronic address: [email protected].; Endocrine Research Unit, Germans Trias i Pujol Research Institute (IGTP) and Service of Endocrinology and Nutrition, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.; Endocrine Research Unit, Germans Trias i Pujol Research Institute (IGTP) and Service of Endocrinology and Nutrition, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Service of Endocrinology and Nutrition, Fundació Privada Hospital Assil de Granollers, Granollers, Spain.; Service of Endocrinology and Nutrition, Hospital General Universitario de Alicante, Alicante, Spain.; Service of Endocrinology and Nutrition, Complejo Hospitalario Universitario de Albacete, Albacete, Spain.; Service of Endocrinology and Nutrition, Hospital Universitario Central de Asturias and ISPA, Oviedo, Spain.; Service of Endocrinology and Nutrition, Hospital Universitario de Son Espases, Palma de Mallorca, Spain.; Service of Endocrinology and Nutrition, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain.; Service of Endocrinology and Nutrition, Hospital Clínic Universitari de València, València, Spain.; Service of Endocrinology and Nutrition, Hospital Universitario and Research Institute la Princesa, Madrid, Spain.; Service of Endocrinology and Nutrition, Hospital Universitario and Research Institute Ramón y Cajal, Madrid, Spain.; Service of Endocrinology and Nutrition, Hospital Universitari Vall d'Hebrón, Barcelona, Spain.; Endocrine Research Unit, Germans Trias i Pujol Research Institute (IGTP) and Service of Endocrinology and Nutrition, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain. Electronic address: [email protected].

DOI: 10.1016/bs.vh.2025.10.006

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MeSH Terms: Humans, Acromegaly, Precision Medicine, Pituitary Neoplasms, Receptors, Somatostatin, Biomarkers, Biomarkers, Tumor, Dopamine Agonists