Patients with acromegaly due to somatotroph adenoma with a high expression ratio of the somatostatin receptors SSTR5/SSTR2, a hyperintense T2-weighted MRI signal, sparse granulation, low AIP expression, high AIP mutation status, low expression of E-cadherin and high expression of Ki-67 are considered good candidates to benefit from pasireotide treatment (12, 18, 39–45). This evidence concerns the gene SSTR5 and familial isolated pituitary adenoma.