TEST:

NETest®

In line with previous studies in non-MEN1 associated NET, in MEN1, a circulating NET gene expression assay identified patients without any manifestations from PanNETs. The mNET assay did not predict PanNET development, progression, or metastasis. The underlying genetic condition, epigenetic modifications, microadenomas and coexistence of multiple manifestations may impact circulating RNA profiles. Further research should explore alternative biomarkers or develop clinico-molecular algorithms for personalized management strategies in MEN1.

Surgical resection remains the cornerstone of treatment for localized disease, while systemic therapies such as everolimus, somatostatin analogs, platinum-based chemotherapy, and peptide receptor radionuclide therapy (PRRT) are options for advanced cases...Advances in molecular profiling, novel imaging techniques, and systemic therapies offer hope for improved outcomes. Given the disease rarity, continued collaboration through registries and multicenter studies is essential to refine evidence-based management strategies.

Interdisciplinary collaborations and global consortia are crucial for overcoming current limitations and translating research findings into clinical practice. These insights hold promise for improving prevention, early detection, and tailored treatments, ultimately enhancing patient outcomes.

According to current systematic review, the value of the NETest both for diagnosis and for prognosis of GEP-NET emerged as robust across different studies. Further prospective analysis on larger GEP-NET series is encouraged to validate this tool, improving patients' diagnosis, management, and follow-up.

P1/2, N=27, Recruiting, University Hospital, Basel, Switzerland | Not yet recruiting --> Recruiting

The assay also demonstrated improved sensitivity for differentiating NETs from other gastrointestinal, pancreatic and lung malignancies. The validation of this tool in geographically diverse cohorts highlights their potential for widespread clinical use.

P1/2; Initiation date: Jun 2024 --> Jan 2025

NETest 2.0 simplified the disease scoring system exhibiting improved diagnostic and prognostic capabilities over NETest 1.0. This optimized, validated blood-based molecular tool provides a powerful approach for diagnostic, prognostic and patient monitoring.

Advances in sequencing technologies may enhance the clinical utility of LB in NENs. Future research should focus on refining LB methods, standardising protocols and exploring applications in high-grade NENs.

P2; Not yet recruiting --> Recruiting | Trial completion date: Dec 2028 --> Mar 2029 | Trial primary completion date: Mar 2028 --> Sep 2028

Among three patients who underwent R0 resection and four treated with peptide receptor radionuclide therapy, the changes in NETest scores closely correlated with disease progression. The NETest demonstrated high diagnostic efficacy and accurate therapeutic monitoring capabilities in a Japanese population.

In Group 2, ROC analysis identified an AUC of 0.909 (95% CI: 0.75-0.100) for prediction of local or metastatic recurrence. Blood NETest scores were associated with PFS and OS in patients with metastatic Si-NENs, along with TGR, CgA > 10 × ULN, and presence of lung metastases.