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NETest2.0® Demonstrates Superior Monitoring Performance Compared with Chromogranin A in Neuroendocrine Tumor
Kiarash Mashayekhi1, Mark Kidd2, Anthony Gulati3
1Department of Surgery, University of North Dakota School of Medicine & Health Sciences, Grand Forks, ND 58203, USA.
Cancers
|July 28, 2026
Summary
Serial NETest2.0® assessment significantly outperformed Chromogranin A (CgA) in monitoring neuroendocrine tumor (NET) progression. This blood-based liquid biopsy offers a more reliable tool for longitudinal surveillance of NETs compared to CgA.
Area of Science:
- Oncology
- Biomarkers
- Molecular Diagnostics
Background:
- Neuroendocrine tumors (NETs) lack reliable biomarkers for effective longitudinal surveillance.
- Current biomarker Chromogranin A (CgA) exhibits low sensitivity, high variability, and poor concordance with disease progression.
- NETest2.0®, a multigene transcriptomic liquid biopsy, assesses NET biologic activity dynamically.
Purpose of the Study:
- To compare the efficacy of serial NETest2.0® measurements against CgA for monitoring NET disease progression.
- To evaluate NETest2.0®'s performance in a real-world registry cohort.
Main Methods:
- Analysis of paired blood samples from 191 NET patients in the RegisterNET program.
- NETest2.0® scores derived from a 51-gene panel via quantitative RT-PCR.
- Comparison of NETest2.0® changes with serum CgA levels and imaging-based assessments (CT, MRI, PET/CT) using RECIST 1.1 criteria.
Main Results:
- NETest2.0® changes demonstrated superior discrimination for progression compared to CgA (AUC 0.893 vs. 0.538, p < 0.0001).
- NETest2.0® thresholds (>0% and >5%) significantly outperformed CgA in surveillance analysis (AUCs 0.860 and 0.822 vs. 0.553, p < 0.0001).
- NETest2.0® changes were the strongest independent predictor of progression (ORs 52.99-61.26, p < 0.0001), while CgA did not significantly contribute.
Conclusions:
- Serial NETest2.0® assessment significantly outperforms CgA in monitoring NET disease activity and progression.
- NETest2.0® provides a more sensitive and accurate blood-based biomarker for longitudinal NET surveillance.
- Findings support integrating NETest2.0® into surveillance strategies to enhance imaging and patient monitoring.
