What medication may be used in inoperable patients with ectopic ACTH-secreting tumors?

Pasireotide is a medication that is particularly effective in the management of patients with ectopic ACTH-secreting tumors, primarily due to its ability to inhibit ACTH secretion. Ectopic ACTH syndrome occurs when non-pituitary tumors produce adrenocorticotropic hormone (ACTH), leading to increased cortisol production from the adrenal glands and resulting in Cushing's syndrome. Pasireotide, a somatostatin analogue, works by binding to somatostatin receptors, which in turn reduces the production of ACTH from these ectopic sources.

This mechanism of action makes pasireotide an important therapeutic option for patients who have tumors that are not amenable to surgical intervention, thereby providing symptom control and helping to manage the elevated cortisol levels associated with the condition. In cases where surgery is not possible or where patients are not suitable candidates for it, pasireotide serves as a critical alternative to help improve outcomes for these patients.

Other medications listed do not have the same targeted effect on ACTH secretion related to ectopic tumors, which is why they are not suitable in this context.