Assessment of NETest Clinical Utility in a U.S. Registry-Based Study.
Adult
Aged
Aged, 80 and over
Biomarkers, Tumor
/ blood
Clinical Decision-Making
/ methods
Disease Progression
Female
Humans
Kaplan-Meier Estimate
Liquid Biopsy
/ instrumentation
Male
Middle Aged
Neoplasm Staging
Neuroendocrine Tumors
/ blood
Prognosis
Reagent Kits, Diagnostic
Registries
/ statistics & numerical data
Watchful Waiting
Young Adult
Biomarker
Carcinoid
Liquid biopsy
NET transcripts
Neuroendocrine
Registry
Journal
The oncologist
ISSN: 1549-490X
Titre abrégé: Oncologist
Pays: England
ID NLM: 9607837
Informations de publication
Date de publication:
06 2019
06 2019
Historique:
received:
28
11
2017
accepted:
09
04
2018
pubmed:
31
8
2018
medline:
21
7
2020
entrez:
31
8
2018
Statut:
ppublish
Résumé
The clinical relevance of molecular biomarkers in oncology management has been recognized in breast and lung cancers. We evaluated a blood-based multigene assay for management of neuroendocrine tumors (NETs) in a real-world study (U.S. registry NCT02270567). Diagnostic accuracy and relationship to clinical disease status in two cohorts (treated and watch-and-wait) were evaluated. Patients with NETs ( NETest diagnostic accuracy was 96% and concordant (95%) with image-demonstrable disease. Scores were reproducible (97%) and concordant with clinical status (98%). The NETest was the only feature linked to PFS (odds ratio, 6.1; Blood NETest is an accurate diagnostic and can be of use in monitoring disease status and facilitating management change in both watch-and-wait and treatment cohorts. A circulating multigene molecular biomarker to guide neuroendocrine tumor (NET) management has been developed because current biomarkers have limited clinical utility. NETest is diagnostic (96%) and in real time defines the disease status (>95%) as stable or progressive. It is >90% effective in guiding treatment decisions in conjunction with diagnostic imaging. Monitoring was effective in watch-and-wait or treatment groups. Low levels supported no management change and reduced the need for imaging. High levels indicated the need for management intervention. Real-time liquid biopsy assessment of NETs has clinical utility and can contribute additional value to patient management strategies and outcomes.
Sections du résumé
BACKGROUND
The clinical relevance of molecular biomarkers in oncology management has been recognized in breast and lung cancers. We evaluated a blood-based multigene assay for management of neuroendocrine tumors (NETs) in a real-world study (U.S. registry NCT02270567). Diagnostic accuracy and relationship to clinical disease status in two cohorts (treated and watch-and-wait) were evaluated.
MATERIALS AND METHODS
Patients with NETs (
RESULTS
NETest diagnostic accuracy was 96% and concordant (95%) with image-demonstrable disease. Scores were reproducible (97%) and concordant with clinical status (98%). The NETest was the only feature linked to PFS (odds ratio, 6.1;
CONCLUSION
Blood NETest is an accurate diagnostic and can be of use in monitoring disease status and facilitating management change in both watch-and-wait and treatment cohorts.
IMPLICATIONS FOR PRACTICE
A circulating multigene molecular biomarker to guide neuroendocrine tumor (NET) management has been developed because current biomarkers have limited clinical utility. NETest is diagnostic (96%) and in real time defines the disease status (>95%) as stable or progressive. It is >90% effective in guiding treatment decisions in conjunction with diagnostic imaging. Monitoring was effective in watch-and-wait or treatment groups. Low levels supported no management change and reduced the need for imaging. High levels indicated the need for management intervention. Real-time liquid biopsy assessment of NETs has clinical utility and can contribute additional value to patient management strategies and outcomes.
Identifiants
pubmed: 30158287
pii: theoncologist.2017-0623
doi: 10.1634/theoncologist.2017-0623
pmc: PMC6656500
doi:
Substances chimiques
Biomarkers, Tumor
0
Reagent Kits, Diagnostic
0
Banques de données
ClinicalTrials.gov
['NCT02270567']
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
783-790Subventions
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
© AlphaMed Press 2018.
Déclaration de conflit d'intérêts
Disclosures of potential conflicts of interest may be found at the end of this article.
Références
Eur J Cardiothorac Surg. 2018 Mar 1;53(3):631-639
pubmed: 29145657
Am J Gastroenterol. 2015 Aug;110(8):1223-32
pubmed: 26032155
Curr Opin Endocrinol Diabetes Obes. 2016 Feb;23(1):28-37
pubmed: 26627724
J Clin Endocrinol Metab. 2015 Nov;100(11):E1437-45
pubmed: 26348352
PLoS One. 2013 May 15;8(5):e63364
pubmed: 23691035
Ann Oncol. 2017 Jun 1;28(6):1309-1315
pubmed: 28327907
Surgery. 2016 Jan;159(1):336-47
pubmed: 26456125
J Clin Oncol. 2012 Dec 1;30(34):4233-42
pubmed: 23071236
J Thorac Oncol. 2014 Oct;9(10):1443-8
pubmed: 25521397
Cancer. 2015 Feb 15;121(4):589-97
pubmed: 25312765
J Clin Oncol. 2017 Aug 20;35(24):2838-2847
pubmed: 28692382
J Natl Compr Canc Netw. 2015 Jan;13(1):78-108
pubmed: 25583772
Endocr Relat Cancer. 2014 Apr 28;21(3):R105-20
pubmed: 24351682
J Natl Cancer Inst. 2008 Sep 17;100(18):1282-9
pubmed: 18780869
Lancet Oncol. 2015 Sep;16(9):e435-e446
pubmed: 26370353
Neuroendocrinology. 2017 Apr 8;105(3):201-211
pubmed: 28391265
Endocr Relat Cancer. 2014 Aug;21(4):615-28
pubmed: 25015994
Cancer Treat Rev. 2016 Jun;47:32-45
pubmed: 27236421
J Clin Oncol. 1997 Jun;15(6):2420-31
pubmed: 9196158
World J Gastroenterol. 2013 Apr 21;19(15):2348-54
pubmed: 23613628
N Engl J Med. 2017 Jan 12;376(2):125-135
pubmed: 28076709
J Clin Oncol. 2017 Oct 20;35(30):3484-3515
pubmed: 28806116
Neuroendocrinology. 2017;104(2):170-182
pubmed: 27078712
Ann Surg. 2004 Nov;240(5):757-73
pubmed: 15492556
J Clin Oncol. 2011 Mar 1;29(7):934-43
pubmed: 21263089
Endocr Relat Cancer. 2015 Aug;22(4):561-75
pubmed: 26037279
Pancreas. 2017 Jul;46(6):707-714
pubmed: 28609356
Eur J Nucl Med Mol Imaging. 2016 May;43(5):839-851
pubmed: 26596723
J Epidemiol. 2018 Feb 5;28(2):61-66
pubmed: 29093355
Endocr Connect. 2016 Sep;5(5):174-87
pubmed: 27582247