IGF1 and adenoma: For example, among patients unresponsive to octreotide/lanreotide, those with T2 MRI hyperintensity are more likely to show improved IGF-I levels while receiving pasireotide (VLQ), and those with lower SST2 and higher SST5 receptor expression are more likely to achieve adenoma shrinkage with pasireotide [123] (LQ).