IGF1 and pituitary tumor: Recommended as first line. SSAs are effective in normalizing IGF-1 and GH levels in approximately 55% of patients. SSAs reduce pituitary tumor size modestly in about 25% to 70% of patients, depending on whether they are used as adjuvant or de novo therapy, respectively. The short-acting subcutaneously administered SSA octreotide is effective, especially when low cost and rapid onset of action is the goal