First-line therapy of acromegaly: a statement of the A.L.I.C.E. (Acromegaly primary medical treatment Learning and Improvement with Continuous medical Education) Study Group.

The A.L.I.C.E. (Acromegaly primary medical treatment Learning and Improvement with Continuous Medical Education) Study Group convened in San Gimignano (Siena) from 6th to 8th July 2006 in order to discuss the modern strategy for the first-line therapy of newly diagnosed patients with acromegaly. The study group consists of clinical endocrinologists and neurosurgeons with experience in clinical management of pituitary diseases, as detailed below. The meeting was organized with the aim of providing a document including reliable criteria upon which a decision of selecting a first-line medical or surgical treatment in patients with acromegaly could be taken. The discussion took into consideration aspects related to the current cure criteria, algorithms of treatment, efficacy/tolerability/costs of currently available medical therapies, efficacy/consequences/ costs of surgery and radiotherapy as function of most modern techniques. Below is the summary of the conclusive indications shared within the group.