This is highlighted by recent literature on personalized management of acromegaly where pasireotide is recommended for use in first-line treatment for patients with certain tumor characteristics that predict resistance to first-generation somatostatins (such as magnetic resonance imaging (MRI) T2 hyperintensity; sparsely granulated tumor; low or negative SSTR2; high SSTR5 positivity; young age; low aryl hydrocarbon receptor-interacting protein mutations; significant tumor volume; low e-cadherin, and high KI-67) (11-13). This evidence concerns the gene MKI67 and neoplasm.