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Serum β-hCG as a Biomarker in Pancreatic Neuroendocrine Tumors: Rethinking Single-Analyte Approach
Paweł Komarnicki1, Paweł Gut1, Maja Cieślewicz1
1Department of Endocrinology, Metabolism and Internal Diseases, Poznan University of Medical Sciences, Przybyszewskiego 49, 60-355 Poznań, Poland.
Abstract:
Despite recent advances, neuroendocrine tumors (NETs) remain a challenging topic, due to their diversity and the lack of suitable biomarkers. Multianalyte assays and the shift to an omics-based approach improve on the conventional single-analyte strategy, albeit with their own drawbacks. We explored the potential of serum β-hCG as a biomarker for NETs and discussed its role in disease monitoring. We recruited 40 patients with non-functioning pancreatic NETs, all with liver metastases. Serum β-hCG concentrations were measured at 3-month intervals over 48 months. We performed a comparative and a repeated measures analysis of β-hCG depending on WHO grade (G1, G2), liver tumor burden (LTB; below 10%, 10-25%), and RECIST 1.1. (stable disease, progressive disease). Patients with progressive disease (p < 0.001), 10-25% LTB (p < 0.001) and WHO Grade 2 (p < 0.001) displayed higher β-hCG concentrations. Throughout the study, β-hCG concentrations consistently increased across the entire cohort. Delta β-hCG during the study period was greater in patients with 10-25% LTB (p < 0.001), progressive disease (p < 0.001), and G2 (p = 0.003). Serum β-hCG correlates with established indicators of malignancy and disease progression in metastatic NETs, supporting further studies as a monitoring and prognostic biomarker. Despite promising results from novel biomarkers, there is still a place for single-analyte assays in NETs.
Insights
Serum beta-human chorionic gonadotropin (β-hCG) shows promise as a biomarker for monitoring neuroendocrine tumors (NETs). Higher concentrations correlate with advanced disease, indicating its potential for tracking NET progression.
Area of Science:
- Oncology
- Endocrinology
- Biomarker Discovery
Background:
- Neuroendocrine tumors (NETs) present diagnostic and monitoring challenges due to heterogeneity and lack of specific biomarkers.
- Current omics-based and multianalyte approaches have limitations, highlighting the need for simpler, effective single-analyte assays.
Purpose of the Study:
- To investigate serum beta-human chorionic gonadotropin (β-hCG) as a potential biomarker for neuroendocrine tumors (NETs).
- To evaluate the role of serum β-hCG in monitoring disease progression in patients with metastatic NETs.
Main Methods:
- Serum β-hCG levels were measured over 48 months in 40 patients with non-functioning pancreatic NETs and liver metastases.
- Analyses correlated β-hCG concentrations with WHO grade, liver tumor burden (LTB), and RECIST 1.1 criteria (stable vs. progressive disease).
Main Results:
- Higher serum β-hCG concentrations were observed in patients with progressive disease, 10-25% LTB, and WHO Grade 2 NETs.
- β-hCG levels consistently increased throughout the study period across the cohort.
- The rate of β-hCG increase (Delta β-hCG) was significantly higher in patients with 10-25% LTB, progressive disease, and G2 NETs.
Conclusions:
- Serum β-hCG levels correlate with established indicators of malignancy and disease progression in metastatic NETs.
- β-hCG demonstrates potential as a valuable monitoring and prognostic biomarker for NETs.
- Single-analyte assays like serum β-hCG measurement remain relevant for NET management alongside novel biomarker strategies.
