Clinical Value of a 51-Neuroendocrine Tumor–Specific Gene Signature (NETest 2.0) for Management of Pancreatic and Small Bowel Neuroendocrine Tumors: A Prospective Study in a Consecutive Cohort of 82 Patients Considered for Surgery
Andrea Frilling, Ashley Clift, Duncan Spalding, Panagiotis Drymousis, Alexander von Roon, Robert Goldin, Jamshed Bomanji, Harpreet Wasa, Abdel B. Halim, Mark KiddObjectives:
To prospectively evaluate the clinical utility of NETest2.0, a 51-neuroendocrine tumor (NET)–specific gene whole blood assay (NETest2.0) for monitoring surgical patients with gastroenteropancreatic NETs (GEPNET).
Background:
GEPNETs are challenging regarding postoperative surveillance and monitoring for recurrence or progression.
Methods:
Blood samples were collected at baseline and during follow-up, and NETest2.0 was measured (scored 0–100; cutoff normal: <50) in 82 consecutive patients with GEPNET. Scores were correlated with follow-up and disease status, including no evidence of disease, stable disease, recurrent disease, and progressive disease.
Results:
Pancreatic NET (n = 29): median age, 57 (26–81) years, M:F (17:12), G1: 19, G2: 8, G3: 2, stages I to III (n = 18), and stage IV (n = 11). Median follow-up, 122 (4–163) months; 7 (24%) died. NETest2.0 correlated with outcomes and was significantly higher in those who died (
Conclusions:
NETest2.0 accurately identified disease status and correlated with clinical outcomes. Patients were stratified into molecular remission, stable disease, and high-risk progression states. Low scores (<50) identified surgical patients unlikely to recur; scores ≥65 identified individuals at increased risk for progression.