New directions in MEN1 management: navigating the new clinical practice guidelines

Area of Science:

• Endocrinology
• Genetics
• Hereditary Syndromes

Background:

• Multiple Endocrine Neoplasia Type 1 (MEN1) presents clinical challenges due to genetic complexity, variable penetrance, and lifelong monitoring requirements.
• Existing management protocols necessitate updates based on evolving clinical experience and molecular understanding.

Purpose of the Study:

• To provide a concise overview of the newly published 2025 MEN1 guidelines.
• To systematically compare the 2025 guidelines with previous versions and other international standards.
• To highlight advancements in genetic interpretation, risk stratification, and therapeutic decision-making for MEN1.

Main Methods:

• Review of the 2025 Multiple Endocrine Neoplasia Type 1 (MEN1) guidelines.
• Systematic comparison of the 2025 MEN1 guidelines against prior guidelines and international standards.
• Analysis of clinical experience and molecular insights informing the updated recommendations.

Main Results:

• The 2025 MEN1 guidelines introduce significant refinements in managing this hereditary syndrome.
• Comparison reveals fundamental advances in genetic interpretation, risk stratification, and treatment decisions.
• Progress towards standardization is noted, alongside persistent controversies in evidence-based, individualized care.

Conclusions:

• The updated 2025 MEN1 guidelines represent a significant step forward in managing this complex endocrine neoplasia syndrome.
• These guidelines emphasize the balance between evidence, pragmatism, and personalized patient care.
• The review identifies crucial directions for future research in Multiple Endocrine Neoplasia Type 1.