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pasireotide (Signifor LAR / pasireotide, LAR / pasireotide LAR)

✓ Approved

Novartis AG · SSTR1 · Small Molecule

What is pasireotide?

pasireotide is a small molecule developed by Novartis AG. It is approved for therapeutic indications via injectable (others) or intramuscular (im) injection or subcutaneous injection.

Drug Profile

Brand NamesSignifor LAR, pasireotide, LAR, pasireotide LAR
CompanyNovartis AG
Drug ClassSmall Molecule, Polypeptide
Molecular TargetSSTR1, SSTR2, SSTR3, SSTR5
RouteInjectable (Others), Intramuscular (IM) Injection, Subcutaneous Injection
StatusApproved
Sources: ClinicalTrials.gov, Novartis AG

Mechanism of Action

Molecular Targets

pasireotide acts on 4 molecular targets:

SSTR1somatostatin receptor 1 (SS-1-R, SS1-R)
SSTR2somatostatin receptor 2 (SST2)
SSTR3somatostatin receptor 3 (SST3, SS3R)
SSTR5somatostatin receptor 5 (SST5, SS-5-R)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

pasireotide is developed for 11 unique indications across 2 therapeutic areas.

Therapeutic AreaConditionPhase
Endocrine disordersAcromegaly✓ Approved
Endocrine disordersPituitary-dependent Cushing's syndrome✓ Approved
Endocrine disordersCarcinoid syndromePhase III
Neoplasms benign, malignant and unspecified (incl cysts and polyps)Colon cancer recurrentPhase III
Neoplasms benign, malignant and unspecified (incl cysts and polyps)Pituitary tumour benignPhase II

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Related Research Articles

PubMedThe American surgeon2026-07-25

Protective Ileostomy After Low Anterior Resection for Rectal Cancer: Modifying the Clinical Course of Anastomotic Leakage at the Cost of Stoma-Related Morbidity.

Yılmaz Mustafa M, Barçin Mahsum M, Özcan Cumhur C, Özkan Uğfe Kuyucuoğlu UK et al.

BackgroundProtective ileostomy (PI) after low anterior resection may not prevent anastomotic leakage (AL) but may lessen its clinical consequences, while adding stoma-related morbidity. This study evaluated the association of PI with the clinical course of AL and stoma-related outcomes.MethodsPatients who underwent total mesorectal excision with low anterior resection after neoadjuvant therapy were retrospectively reviewed and grouped as LAR alone (n = 10) or LAR + PI (n = 74). Main outcomes were AL severity, management, leak-related mortality, AL incidence, and PI-related morbidity, including closure outcomes.ResultsAmong 84 patients, AL occurred in 5.9% (5/84), without a significant difference (LAR 10.0% vs LAR + PI 5.4%; P = 0.478). Reoperation was required in one LAR patient and two PI patients; two PI patients were managed with percutaneous drainage. Leak-related mortality occurred in one LAR patient and none in the PI group. Length of stay was longer with PI (median 10.0 days, interquartile range [IQR] 9.0-11.0) than without PI (7.5 days, IQR 6.0-8.0; P < 0.001). Protective ileostomy-related complications included outlet obstruction (9.5%), surgical site infection (4.1%), bleeding (4.1%), and parastomal hernia (2.7%). Closure was achieved in 90.5% after a median of 180 days (IQR 142.5-273); post-closure complications included obstruction (9.2%), infection (4.6%), small-bowel leak (4.6%), and bleeding (1.5%).DiscussionProtective ileostomy was not associated with a statistically significant reduction in anastomotic leakage incidence but appeared to be associated with a more favorable clinical course when leakage occurred, including lower mortality and the feasibility of less invasive management.

PMID 42498704
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PubMedFrontiers in oncology2026-07-25

Analysis of clinicopathological features and prognosis of mesenteric versus anti-mesenteric rectal cancer: a single-center retrospective cohort study.

Hao Dalei D, Dong Longzhan L, Xi Xiangpeng X, Liu Yulin Y et al.

The mesorectal and anti-mesorectal sides of the rectum differ considerably in embryonic origin, blood supply, lymphatic distribution, and anatomical relations. Tumor location (mesenteric vs. anti-mesenteric) may therefore influence tumor biology and clinical outcomes. This study aimed to evaluate the impact of axial tumor location on clinicopathological features and prognosis in rectal cancer using preoperative high-resolution pelvic MRI. We retrospectively reviewed 380 rectal cancer patients who underwent radical resection between January 2017 and July 2023. Based on preoperative MRI axial images, tumors were classified by their deepest point of invasion relative to the rectal lumen: the mesenteric side group (3-9 o'clock, posterior/posterolateral walls, n=213) and the anti-mesenteric side group (9-3 o'clock, anterior/anterolateral walls, n=167). Demographic, clinicopathological, surgical, and survival data were compared between groups. Among the 380 patients, 213 were assigned to the mesenteric side tumor group and 167 to the anti-mesenteric side tumor group. Baseline characteristics, including age, gender, BMI, TNM stage, MRF status, EMVI, and vascular/nerve invasion, did not differ significantly between two groups (all P > 0.05). With a median follow-up of 56 months, the 3-year local recurrence-free survival (LRFS) rate was significantly lower in the anti-mesenteric group than in the mesenteric group (91.6% vs. 97.1%, P = 0.029). No significant differences were observed in 3-year disease-free survival (83.2% vs. 82.1%, P = 0.832) or overall survival (85.6% vs. 81.7%, P = 0.501) between the two groups. Multivariable Cox regression analysis identified age (HR = 1.043, P = 0.002), surgical procedure (APR vs. LAR, HR = 1.967, P = 0.022), pathological T stage (HR = 2.800, P = 0.023), and pathological N stage (HR = 3.683, P < 0.001) as independent prognostic factors for overall survival. Pathological N stage was the sole independent predictor for disease-free survival (HR = 3.088, P < 0.001). Although axial location was not an independent predictor of overall or disease-free survival (P > 0.05), it was significantly associated with LRFS (anti-mesenteric vs. mesenteric: HR = 2.684, 95% CI: 1.126-6.398, P = 0.026) along with pathological N stage (HR = 3.960, 95% CI: 1.316-11.919, P = 0.014).These findings suggest that anti-mesenteric tumor location is an independent predictor of increased local recurrence risk, providing valuable information for surgical planning and postoperative surveillance beyond conventional staging. Anti-mesenteric rectal tumors are associated with a higher risk of local recurrence, likely due to complex local anatomy and surgical challenges. While pathological N stage, pathological T stage, age, and surgical procedure remain primary independent prognostic factors for survival outcomes, preoperative MRI assessment of axial location provides valuable supplemental information that may help stratify local recurrence risk, refine surgical planning, and optimize postoperative monitoring.

PMID 42500279
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PubMedApplied radiation and isotopes : including data, instrumentation and methods for use in agriculture, industry and medicine2026-07-24

Organ dose and lifetime attributable cancer risk from abdominal CT examinations: A multicentre retrospective study in Jordan.

Alshipli Marwan M, Albadarneh Laith L, Ewaidat Haytham Ahmad Al HAA, Lubad Esraa Abu EA et al.

To quantify effective dose (ED), organ doses, and lifetime attributable risk (LAR) from adult abdominal CT, and assess age- and sex-related variation. A retrospective analysis was conducted between May 2021 and June 2023, including 1409 adult patients (855 males, 554 females). Patient demographics and dose indices (volume CT dose index (CTDIvol) and dose length product (DLP)) were extracted from PACS. Organ doses were calculated using the Monte Carlo based VirtualDose™ platform, and ED was estimated from DLP using an anatomy appropriate conversion coefficient. LAR for cancer incidence and mortality was estimated using age- and sex-specific Biological Effects of Ionising Radiation (BEIR) VII risk models. Mean ED varied modestly across age bands and sexes, with a cohort mean of 12.95 mSv. The liver consistently received the highest absorbed dose (20-30 years: 33.68 mGy; 70-80 years: 32.00 mGy), while stomach and colon doses were similar across age bands (10.67-11.23 mGy). LAR showed a clear age gradient, with the highest values in 18-20 years and the lowest in 70-80 years for both sexes. Females had higher stomach LAR and males higher colon LAR. Despite higher liver dose, the colon had the highest projected LAR, reflecting organ-specific risk coefficients. Younger adults have higher lifetime cancer risk from abdominal CT despite broadly similar ED across age bands, suggesting that the age gradient is biologically driven rather than dose-driven. These findings support strengthened justification, age- and sex-specific protocol optimisation, and systematic dose auditing to minimise radiation exposure while maintaining diagnostic performance.

PMID 42492398
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PubMedJournal of investigative medicine : the official publication of the American Federation for Clinical Research2026-07-24

EXPRESS: Association between serum lactate/albumin ratio and all-cause mortality in critically ill patients: a meta-analysis.

Liu Xinwei X, Xie Xiulin X, Zhao Chen C, Zhu Longyan L et al.

Lactate and albumin are routine biomarkers reflecting tissue perfusion and nutritional/inflammatory status, respectively. The serum lactate/albumin ratio (LAR), as a composite indicator, may complement single-parameter measures in disease assessment. However, its association with all-cause mortality in critically ill patients lacks systematic quantification across broad populations. We searched PubMed, Embase, Cochrane Library, and Web of Science through February 18, 2025, for observational studies linking LAR to all-cause mortality in critically ill adults. Two investigators independently selected studies, extracted data, and assessed quality. Hazard Ratios (HR) were pooled for survival analysis, and diagnostic accuracy measures were synthesized using Stata 15.1. The certainty of evidence was rated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. A total of 29 studies comprising 39,681 patients were included. Elevated LAR was significantly associated with increased short-term (HR 2.63, 95% confidence interval (CI): 2.27-3.04) and long-term all-cause mortality (HR 2.21, 95% CI: 1.70-2.86). Pooled sensitivity, specificity, and summary area under the curve were 0.71 (95% CI: 0.64-0.77), 0.74 (95% CI: 0.69-0.78), and 0.78 (95% CI: 0.75-0.82), respectively, indicating moderate-to-good predictive performance. Subgroup analyses confirmed stability across countries, data sources, disease types, and measurement times. GRADE certainty was high for short-term mortality and low for long-term mortality and diagnostic accuracy. In conclusion, elevated LAR was associated with increased short-term (high-certainty) and long-term mortality (low-certainty) in critically ill patients. Given its accessibility and low cost, LAR may complement established scoring systems for early risk stratification, though prospective validation and standardised cut-offs are needed.

PMID 42495757
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PubMedPituitary2026-07-24

Ex Vivo drug sensitivity in patient-derived 3D cultures in acromegaly and its association with clinical predictors.

Tsujimoto Yasutaka Y, Ishida Atsushi A, da Silva Frederico Gaia Costa FGC, Shichi Hiroki H et al.

Personalized therapy in acromegaly is limited by interindividual variability in drug responses and the lack of robust markers predicting tumor shrinkage, rather than biochemical control alone. To test whether ex vivo drug-induced viability changes in patient-derived 3D cultures (Pd3D) of GH-secreting pituitary adenomas reflect tumor cell-intrinsic pharmacological sensitivity and align with established clinical predictors. Spheroid-based Pd3D cultures were established from 27 patients with acromegaly. Cultures were exposed to octreotide, cabergoline, pasireotide, or vehicle control. We assessed cell viability changes; sample-level responder status (viability reduction vs vehicle, p < 0.05); and associations between responder status and known predictive markers, including clinical characteristics, MRI findings, dynamic drug tests, and pathological features. In 6 cases, AI-based digital image analysis quantified pre- and post-treatment SSTR2 expression in liquid-based cytology (LBC). All agents modestly reduced median cell viability (84-86%, p < 0.05), with responder rates of 33-40%. Concordance with established predictors was observed: octreotide responders correlated with T2 hypointensity (88% vs 44%, p = 0.04); cabergoline with positive bromocriptine tests (100% vs 45%, p = 0.03); and pasireotide with sparsely granulated patterns (64% vs 19%, p = 0.04). AI-based dynamic analysis demonstrated that ex vivo responders showed relatively stable SSTR2 expression after treatment, whereas nonresponders exhibited marked depletion. Spheroid-based Pd3D ex vivo viability assays revealed modest but significant cohort-level effects and sample-level concordance with clinical predictors, suggesting its potential utility as an exploratory model. Additionally, AI-based quantification of SSTR2 dynamics captured functional receptor shifts.

PMID 42496773
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PubMedClinical and translational gastroenterology2026-07-21

Comparative Efficacy and Safety of Octreotide, Lanreotide, and Pasireotide in ADPKD and PLD: A Network Meta-analysis with Real-world Evidence from the FAERS Database.

Mei Ziwei Z, Chen Jun J, Fan Junfen J, Fan Zhenliang Z et al.

Somatostatin analogs were the primary treatment for autosomal dominant polycystic kidney disease (ADPKD) or polycystic liver disease (PLD), including octreotide, lanreotide, and pasireotide. We compared the effects and safety of octreotide, lanreotide, and pasireotide on total kidney volume (TKV), total liver volume (TLV), and kidney function (eGFR) in patients with ADPKD or PLD using network meta-analysis and FDA Adverse Event Reporting System (FAERS) data. Pooled estimates from limited available trials suggested that, at 6 months or 1 year, octreotide (MD: -3.7, 95%CI: -4.3 to -3.2) and pasireotide (-5.0, -8.2 to -1.8) were associated with preliminary evidence of TKV reduction compared with placebo. However, lanreotide (-7.8, -10.2 to -5.4) obviously manifested a decrease in the TKV after more than 2 years. TLV analyses showed early directional effects of octreotide (-7.7, -12.1 to -3.3) and pasireotide (-9.0, -13.7 to -4.3) at 1 year, and for lanreotide (-5.0, -6.3 to -3.9) after more than 2 years. Lanreotide demonstrated inferior efficacy in reducing the TLV growth rate compared to octreotide (10.0, 2.7 to 18.0) following a 2-3 year administration period. Cholelithiasis is the most common biliary adverse event in three somatostatin analogs. Cox regression identified age (HR: 0.966, 95% CI: 0.949 to 0.982, P < 0.001) and drug (HR: 2.168, 95% CI: 1.411 to 3.332, P < 0.001) as independent predictors of cholelithiasis. The onset time of TKV/TLV reduction differs among the three somatostatin analogs. Age and drug were independent predictors of cholelithiasis. Younger patients or those receiving pasireotide are at higher risk of cholelithiasis.

PMID 42476150
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