Pasireotide has shown effectiveness in normalizing GH and IGF-1 secretions, as well as reducing the pituitary mass both in medically naïve patients with active acromegaly after prior pituitary surgery and in treatment naïve de novo diagnosed patients.12−14 Preliminary reports and case studies suggest that it may also have utility in treatment-resistant macro-prolactinoma.6,7,15,16. This evidence concerns the gene IGF1 and acromegaly.