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PRRT neuroendocrine tumor response monitored using circulating transcript analysis: the NETest.

Lisa Bodei1,2, Mark S Kidd3, Aviral Singh4

  • 1Molecular Imaging and Therapy Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, Box 77, New York, NY, 10065, USA. bodeil@mskcc.org.

European Journal of Nuclear Medicine and Molecular Imaging
|December 16, 2019
PubMed
Summary
This summary is machine-generated.

Blood biomarkers NETest and PPQ accurately predict and monitor treatment response in neuroendocrine tumors (NETs) undergoing peptide receptor radionuclide therapy (PRRT). NETest serves as a reliable surrogate for radiological assessment, correlating with PRRT efficacy.

Keywords:
BiomarkerLiquid biopsyNETestNeuroendocrinePPQPRRT

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Area of Science:

  • Oncology
  • Nuclear Medicine
  • Biomarker Research

Background:

  • Peptide receptor radionuclide therapy (PRRT) is a key treatment for metastatic/inoperable neuroendocrine tumors (NETs).
  • Assessing treatment response typically relies on imaging after therapy completion.
  • Real-time monitoring using blood biomarkers like PRRT Predictive Quotient (PPQ) and NETest offers a more immediate evaluation of efficacy.

Purpose of the Study:

  • To evaluate NETest as a surrogate biomarker for RECIST (Response Evaluation Criteria In Solid Tumors) in PRRT.
  • To assess the correlation between NETest levels and PPQ predictions for PRRT response.

Main Methods:

  • A prospective study involving three independent cohorts (n=157) of patients with GEP-NET and lung NETs treated with 177Lu-PRRT.
  • Treatment response was assessed using RECIST 1.1 criteria.
  • Blood samples were collected pre-PRRT, during treatment, and during follow-up (2-12 months) for PPQ and NETest analysis (PCR), with CgA (ELISA) as a comparator.

Main Results:

  • NETest significantly decreased in RECIST responders (-47%) and increased in non-responders (+79%), achieving 98% monitoring accuracy.
  • PPQ demonstrated 97% accuracy in predicting PRRT response.
  • NETest levels correlated strongly with PPQ predictions and significantly with progression-free survival (PFS).
  • Chromogranin A (CgA) levels did not reliably reflect PRRT treatment response.

Conclusions:

  • PPQ accurately predicts PRRT response in 97% of cases.
  • NETest is an effective surrogate marker for radiological response assessment in PRRT, accurately monitoring treatment effectiveness.
  • NETest decrease identifies responders and correlates with PPQ predictions, while CgA proved non-informative.