Endocrine Abstracts

Background: The NETest is a multi-gene assay comprising 51 circulating neuroendocrine tumor specific transcripts. The quotient of the 51-gene assay is based upon multi-algorithmic data analysis. Eight cancer hallmarks or ‘omes’ (apoptome, epigenome, growth factor signalome, metabolome, proliferome, plurome, secretome SSTRome) represent 29 genes. The NETest is an accurate diagnostic (>90%) but its prognostic utility has not been assessed. In this study, we describe ex...

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: 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...

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...

Background: Surgery is the only curative treatment for gastroenteropancreatic neuroendocrine tumors (GEP-NETs), but the prediction of residual disease/recurrence is limited in the absence of optimal biomarkers. We examined whether a blood-based multianalyte neuroendocrine gene transcript assay (NETest) would define tumor cytoreduction and therapeutic efficacy.Methods: The NETest is a polymerase chain reaction–based analysis of 51 genes. Disease acti...

Introduction: Surgery is the only cure for neuroendocrine tumor (NET) disease. R0 resection is critical for successful tumor resection. Early detection of residual disease is key for optimal management. Both imaging and current biomarkers have intrinsic limitations and are largely ineffective up to 3 months post-surgery. NETest, a multigene blood biomarker test, identifies NETs with >90% accuracy. We hypothesized that surgery would decrease NETest levels and that elevated scor...