Our results confirmed that Pasireotide Lar, Pegvisomant in monotherapy or in combination with SSA are safe and effective in reaching the control of acromegaly and underline that in SSA-resistant GH secreting pituitary adenomas, c-Peg-V and Pasireotide-Lar are choose for the treatment of invasive tumors. This evidence concerns the gene GH1 and pituitary gland adenoma.