In patients with predictors of poor response to first-generation somatostatin analogs, such as T2-weighted MRI hyperintensity and poor GH suppression during acute octreotide testing, early consideration of pasireotide (PAS) or combination therapy with PAS and pegvisomant (PEG) may be appropriate. In this case, PAS up to 60 mg every 4 weeks failed to adequately control IGF-1 levels, whereas subsequent combination therapy with PAS and PEG achieved biochemical remission and tumor stabilization, highlighting the potential role of combination strategies in aggressive acromegaly.

Preoperative management included long-acting octreotide, niacin, and guideline-directed heart failure therapy, followed by tumor resection...Primary ovarian neuroendocrine neoplasms can cause carcinoid syndrome and right-sided valvulopathy without liver metastasis, likely because ovarian venous drainage bypasses hepatic first-pass metabolism. Multidisciplinary care enables prompt diagnosis, preoperative stabilization, definitive resection, and coordinated surveillance.

P=N/A, N=200, Recruiting, Camurus AB | Not yet recruiting --> Recruiting

P3, N=154, Not yet recruiting, CSPC ZhongQi Pharmaceutical Technology Co., Ltd.

P=N/A, N=200, Not yet recruiting, Camurus AB

The multifaceted actions and effects of somatostatin make it useful as a potential therapeutical means in various pathologies; however, in clinical practice, somatostatin analogues, namely octreotide, lanreotide and pasireotide, are commonly used instead, due to their increased half-life and increased receptor selectivity, with pasireotide showing a more extensive receptor binding profile and high affinity for somatotastin receptor (SSTR) 5, which may prove effective in cases of resistance to first-generation analogues...They have also been used in some cases, with varying degrees of success, in patients with post-surgical gastrointestinal and lymphatic fistulas, refractory chronic diarrhoea and polycystic kidney disease; many applications in paediatric patients have also been documented. The aim of this review is to present the applications of somatostatin and its analogues as alternative or second-line therapies, along with insights into their effectiveness and future potential.

P1, N=10, Active, not recruiting, Memorial Sloan Kettering Cancer Center | Trial completion date: Sep 2026 --> Sep 2027 | Trial primary completion date: Sep 2026 --> Sep 2027

The patient underwent cytoreductive debulking surgery, achieving approximately 70% tumor reduction, followed by long-acting octreotide therapy...This case report underscores the importance of early recognition and a multidisciplinary approach in managing indolent neuroendocrine tumors with multisite metastases. Combined surgical and medical strategies, including debulking surgery and octreotide therapy, can achieve durable disease control and favorable outcomes.

P2/3, N=256, Completed, Grupo Espanol de Tumores Neuroendocrinos | Active, not recruiting --> Completed

P1/2, N=32, Suspended, Alexion Pharmaceuticals Inc. | Recruiting --> Suspended

Treatment with somatostatin, cortistatin, octreotide or pasireotide did not exert clear antitumoral effects on model cell lines...Molecular analysis revealed a generalized dephosphorylation affecting key proliferation, growth and cell survival pathways in response to BIM-23120 (unlike when treating with octreotide). Altogether, our results provide novel information on the status of the somatostatin system in PPGL and identify new potential therapeutic tools selectively targeting somatostatin receptors on this refractory tumor.

Clinical management often requires a multimodal approach including titration of DA to higher than usual doses, surgical resection or debulking, and targeted radiotherapy. Robust evidence is lacking for non-approved adjunct therapies, such as aromatase inhibitors and estrogen receptor modulators, although the somatostatin receptor ligand pasireotide may have potential in select patients.