Circulating Biomarkers of GEP and Lung NENs: ‘The Times they are a Changin’

Abstract Biomarkers that are secretory monoanalyte products of GEP (gastro-entero-pancreatic) and BP (broncho-pulmonary) or lung NETs (neuroendocrine tumors) have significant limitations in clinical utility. The assessment of secretory activity provides little information in regard to tumor biology. Furthermore, ∼50% of NETs have measurable secretory products. Molecular genomic identification in blood (NETest liquid biopsy) of the regulators of tumor biology provide multianalyte, real-time assessment of tumor status. These data represent the assessment of ∼2,000 NETs over 5 years and demonstrates the NETest has ∼95% accuracy in GEPNET and BPNET diagnosis, is >90% concordant with imaging,and 90% accurate in differentiating stable from progressive disease. The comparable metrics for CgA are all ∼50%. In addition, the NETest identifies complete surgical resection in 100% and has a 98% efficacy in monitoring peptide receptor radionuclide therapy (PRRT) efficacy. Real-time liquid biopsy assessment of NET disease provides a non-invasive, accurate strategy to define the NET patient journey. ‘The times they are a changin’….