Abstract
Context: Early and precise delineation of therapeutic responses are key issues in neuroendocrine neoplasm/tumor management. Imaging is currently used but exhibits limitations in sensitivity and specificity. The utility of biomarkers is unclear. Objective, Setting, and Design: This prospective cohort study (11mo)sought to determine whether measurements of circulating neuroendocrine tumor transcripts (NETest) predict responses to somatostatin analogs (SSAs). Patients: The test set consisted of 35 SSA-treated gastroenteropancreatic-NETs (RECISTevaluated). The prospective set consisted of 28 SSA-treated Grade 1-Grade 2 GEP-NETs. Intervention(s): Whole blood for transcript analysis (NETest) and plasma for ChromograninA(CgA) (baseline), were collected every 4 weeks (prior to SSA injection). Morphologic (multidetector computed tomography/MRI) and functional imaging (99mTc-[HYNIC, Tyr3]-Octreotide) was undertaken at entry and 6-month intervals until progression (RECIST 1.0). Main Outcome Measure(s): Treatment response. Results: Test set: NETest (≥80%; scale, 0-100%) differentiated stable (SD) and progressive (PD) disease (P25% increase; eight developed PD; four, SD. NETest (P=.002) and grade (P=.054) were the only factors associated with treatment response. Multiple regression analysis established that the NETest could predict disease progression (P=.0002). NETest changes occurred significantly earlier (146 d prior to progression vs 56 d CgA; P <.0001; χ2 = 19) and in more patients (100 vs 57%; P <.02). Conclusions: NETest values (80-100%) were more accurate and occurred at a significantly earlier time point than CgA and predicted SSA treatment response.
| Original language | English |
|---|---|
| Pages (from-to) | E1437-E1445 |
| Journal | Journal of Clinical Endocrinology and Metabolism |
| Volume | 100 |
| Issue number | 11 |
| DOIs | |
| Publication status | Published - Nov 1 2015 |
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ASJC Scopus subject areas
- Biochemistry
- Clinical Biochemistry
- Endocrinology
- Biochemistry, medical
- Endocrinology, Diabetes and Metabolism
Cite this
Circulating transcript analysis (NETest) in GEP-NETs treated with somatostatin analogs defines therapy. / Ćwikła, Jarosław B.; Bodei, Lisa; Kolasinska-Ćwikła, Agnieszka; Sankowski, Artur; Modlin, Irvin M.; Kidd, Mark.
In: Journal of Clinical Endocrinology and Metabolism, Vol. 100, No. 11, 01.11.2015, p. E1437-E1445.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Circulating transcript analysis (NETest) in GEP-NETs treated with somatostatin analogs defines therapy
AU - Ćwikła, Jarosław B.
AU - Bodei, Lisa
AU - Kolasinska-Ćwikła, Agnieszka
AU - Sankowski, Artur
AU - Modlin, Irvin M.
AU - Kidd, Mark
PY - 2015/11/1
Y1 - 2015/11/1
N2 - Context: Early and precise delineation of therapeutic responses are key issues in neuroendocrine neoplasm/tumor management. Imaging is currently used but exhibits limitations in sensitivity and specificity. The utility of biomarkers is unclear. Objective, Setting, and Design: This prospective cohort study (11mo)sought to determine whether measurements of circulating neuroendocrine tumor transcripts (NETest) predict responses to somatostatin analogs (SSAs). Patients: The test set consisted of 35 SSA-treated gastroenteropancreatic-NETs (RECISTevaluated). The prospective set consisted of 28 SSA-treated Grade 1-Grade 2 GEP-NETs. Intervention(s): Whole blood for transcript analysis (NETest) and plasma for ChromograninA(CgA) (baseline), were collected every 4 weeks (prior to SSA injection). Morphologic (multidetector computed tomography/MRI) and functional imaging (99mTc-[HYNIC, Tyr3]-Octreotide) was undertaken at entry and 6-month intervals until progression (RECIST 1.0). Main Outcome Measure(s): Treatment response. Results: Test set: NETest (≥80%; scale, 0-100%) differentiated stable (SD) and progressive (PD) disease (P25% increase; eight developed PD; four, SD. NETest (P=.002) and grade (P=.054) were the only factors associated with treatment response. Multiple regression analysis established that the NETest could predict disease progression (P=.0002). NETest changes occurred significantly earlier (146 d prior to progression vs 56 d CgA; P <.0001; χ2 = 19) and in more patients (100 vs 57%; P <.02). Conclusions: NETest values (80-100%) were more accurate and occurred at a significantly earlier time point than CgA and predicted SSA treatment response.
AB - Context: Early and precise delineation of therapeutic responses are key issues in neuroendocrine neoplasm/tumor management. Imaging is currently used but exhibits limitations in sensitivity and specificity. The utility of biomarkers is unclear. Objective, Setting, and Design: This prospective cohort study (11mo)sought to determine whether measurements of circulating neuroendocrine tumor transcripts (NETest) predict responses to somatostatin analogs (SSAs). Patients: The test set consisted of 35 SSA-treated gastroenteropancreatic-NETs (RECISTevaluated). The prospective set consisted of 28 SSA-treated Grade 1-Grade 2 GEP-NETs. Intervention(s): Whole blood for transcript analysis (NETest) and plasma for ChromograninA(CgA) (baseline), were collected every 4 weeks (prior to SSA injection). Morphologic (multidetector computed tomography/MRI) and functional imaging (99mTc-[HYNIC, Tyr3]-Octreotide) was undertaken at entry and 6-month intervals until progression (RECIST 1.0). Main Outcome Measure(s): Treatment response. Results: Test set: NETest (≥80%; scale, 0-100%) differentiated stable (SD) and progressive (PD) disease (P25% increase; eight developed PD; four, SD. NETest (P=.002) and grade (P=.054) were the only factors associated with treatment response. Multiple regression analysis established that the NETest could predict disease progression (P=.0002). NETest changes occurred significantly earlier (146 d prior to progression vs 56 d CgA; P <.0001; χ2 = 19) and in more patients (100 vs 57%; P <.02). Conclusions: NETest values (80-100%) were more accurate and occurred at a significantly earlier time point than CgA and predicted SSA treatment response.
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UR - http://www.scopus.com/inward/citedby.url?scp=84958641689&partnerID=8YFLogxK
U2 - 10.1210/jc.2015-2792
DO - 10.1210/jc.2015-2792
M3 - Article
C2 - 26348352
AN - SCOPUS:84958641689
VL - 100
SP - E1437-E1445
JO - Journal of Clinical Endocrinology and Metabolism
JF - Journal of Clinical Endocrinology and Metabolism
SN - 0021-972X
IS - 11
ER -