Endocrine Abstracts

Neuroendocrine tumours (NETs) tend to be slow growing (although aggressive forms exist) and are often diagnosed when they have already metastasised.Treatment of NETs is typically multidisciplinary and should be individualised according to the tumour type, burden, and symptoms. Therapeutic tools in NETs include surgery, interventional radiology and medical treatments such as somatostatin analogues, interferon, chemotherapy, new targeted drugs and peptide ...

Background: No effective blood biomarker exists to detect and clinically manage bronchopulmonary (BP) neuroendocrine tumors. We developed a blood-based 51 neuroendocrine tumor (NET)-specific transcript set to diagnose and monitor gastroenteropancreatic NETs. In this study, we examined whether the signature functioned in lung NETs. Thereafter, we examined performance metrics to assess clinical utility. The multianalyte gene signature accurately diagnosed the tumor and in additi...

Background: The diagnosis of neuroendocrine tumor disease has been tardy due to a lack of sensitive, noninvasive technology to facilitate identification. In the 1960’s, diagnosis required tumor tissue attained by surgery or biopsy. Identification was by histopathology and immunohistochemistry (1975). Acquisition of information was limited by the morbidity of invasive strategies, inability to reassess and interpretation was user-dependent with low kappa values. The introdu...

Background: Peptide receptor radionuclide therapy (PRRT) is based on tumor somatostatin receptor (SSR) overexpression to deliver targeted isotope therapy. Functional imaging of SSR expression (SRE) is used as a predictor of efficacy, but there is no method to objectively predict PRRT efficacy. We report the efficacy of Predictive Quotient Index (PQI) to predict the utility of PPRT. PQI is derived from circulating NET transcript analysis (NETest) integrated with the tu...

Background: There are no effective blood biomarkers for bronchopulmonary carcinoids (BPC). We examined the utility of a neuroendocrine multigene transcript ‘liquid biopsy’ (NETest) in bronchopulmonary carcinoids (BPC) for diagnosis and monitoring of disease status.Aim: To independently validate the utility of the NETest in diagnosis and management of BPC in a prospective multicenter, multinational blinded study.Material a...

Background: 177Lu-DOTATATE is an FDA and Health Canada-approved treatment option for metastatic, progressive GEPNET patients. 177Lu-DOTATATE is now often considered the treatment of choice for small bowel/midgut patients who have progressed on somatostatin analogs (SSA). Despite 177Lu- DOTATATE’s impressive disease stabilization, many patients will eventually progress. Progression after prior use of PRRT does not necessarily render these tumors resistant to future PRRT tr...

Background: Predicting and monitoring PRRT is based upon NET overexpression of somatostatin receptor (SSR) to deliver targeted isotope therapy. Imaging SSR expression is ~60% accurate as a predictor of efficacy. However, it and other imaging modalities e.g., CT/MRI, have utility for monitoring response. Specific blood NET gene expression (Positive Predictor Quotient- [PPQ]) is accurate in predicting PRRT response (93–97%, Bodei et al. EJNMMI 2018). The utility of NET tran...

Introduction: There is a substantial unmet clinical need for an accurate and effective blood biomarker for gastroenteropancreatic neuroendocrine tumours (GEP-NETs). Current monoanalyte biomarkers are ineffective. The NETest, a novel multianalyte signature, provides molecular information relevant to disease biology. We therefore evaluated, under real-world conditions, the clinical utility of the NETest as a liquid biopsy in GEP-NETs.Aim(s): Independently ...

Background: The efficacy of PRRT is based upon NET over expression of somatostatin receptor (SSR) to deliver targeted isotope therapy. SSR expression (Krenning scale) compared to Predictive Quotient Index (PQI) (circulating NET transcript analysis mathematically integrated with grade) indicates the latter is more accurate for predicting PRRT efficacy. We evaluated whether PQI was specifically predictive or was prognostic for PRRT compared to other therapeutic strategi...

Background: There is currently no effective blood biomarker for lung neuroendocrine neoplasia diagnosis and management. We describe the clinical utility of a 51 neuroendocrine-specific gene expression set in blood to diagnose bronchopulmonary neuroendocrine tumors (BPNETs) and define their clinical status.Methods: The discovery set included BPNETs (n=154) and controls (n=90), randomly assigned (1:1) to a test and validation set. Specifi...