Most studies of first-line therapy of acromegaly with somatostatin analogues evaluated octreotide LAR, and recent studies have demonstrated that first-line therapy with octreotide LAR reduces GH and IGF-1 levels to a similar or greater extent than when administered after surgery and/or radiotherapy (Table 3) [99-106], and reduces pituitary tumor size (usually defined as a 10-25% reduction) in most patients (Table 3 and Figure 3) [99-107]. Here, IGF1 is linked to pituitary tumor.