A Delphic consensus assessment: imaging and biomarkers in gastroenteropancreatic neuroendocrine tumor disease management
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A Delphic consensus assessment : imaging and biomarkers in gastroenteropancreatic neuroendocrine tumor disease management. / Oberg, Kjell; Krenning, Eric; Sundin, Anders; Bodei, Lisa; Kidd, Mark; Tesselaar, Margot; Ambrosini, Valentina; Baum, Richard P; Kulke, Matthew; Pavel, Marianne; Cwikla, Jaroslaw; Drozdov, Ignat; Falconi, Massimo; Fazio, Nicola; Frilling, Andrea; Jensen, Robert; Koopmans, Klaus; Korse, Tiny; Kwekkeboom, Dik J; Maecke, Helmut; Paganelli, Giovanni; Salazar, Ramon; Severi, Stefano; Strosberg, Jonathan; Prasad, Vikas; Scarpa, Aldo; Grossman, Ashley; Walenkamp, Annemeik; Cives, Mauro; Virgolini, Irene; Kjaer, Andreas; Modlin, Irvin M.
In: Endocrine Connections, Vol. 5, No. 5, 09.2016, p. 174-187.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - A Delphic consensus assessment
T2 - imaging and biomarkers in gastroenteropancreatic neuroendocrine tumor disease management
AU - Oberg, Kjell
AU - Krenning, Eric
AU - Sundin, Anders
AU - Bodei, Lisa
AU - Kidd, Mark
AU - Tesselaar, Margot
AU - Ambrosini, Valentina
AU - Baum, Richard P
AU - Kulke, Matthew
AU - Pavel, Marianne
AU - Cwikla, Jaroslaw
AU - Drozdov, Ignat
AU - Falconi, Massimo
AU - Fazio, Nicola
AU - Frilling, Andrea
AU - Jensen, Robert
AU - Koopmans, Klaus
AU - Korse, Tiny
AU - Kwekkeboom, Dik J
AU - Maecke, Helmut
AU - Paganelli, Giovanni
AU - Salazar, Ramon
AU - Severi, Stefano
AU - Strosberg, Jonathan
AU - Prasad, Vikas
AU - Scarpa, Aldo
AU - Grossman, Ashley
AU - Walenkamp, Annemeik
AU - Cives, Mauro
AU - Virgolini, Irene
AU - Kjaer, Andreas
AU - Modlin, Irvin M
N1 - © 2016 The authors.
PY - 2016/9
Y1 - 2016/9
N2 - The complexity of the clinical management of neuroendocrine neoplasia (NEN) is exacerbated by limitations in imaging modalities and a paucity of clinically useful biomarkers. Limitations in currently available imaging modalities reflect difficulties in measuring an intrinsically indolent disease, resolution inadequacies and inter-/intra-facility device variability and that RECIST (Response Evaluation Criteria in Solid Tumors) criteria are not optimal for NEN. Limitations of currently used biomarkers are that they are secretory biomarkers (chromogranin A, serotonin, neuron-specific enolase and pancreastatin); monoanalyte measurements; and lack sensitivity, specificity and predictive capacity. None of them meet the NIH metrics for clinical usage. A multinational, multidisciplinary Delphi consensus meeting of NEN experts (n = 33) assessed current imaging strategies and biomarkers in NEN management. Consensus (>75%) was achieved for 78% of the 142 questions. The panel concluded that morphological imaging has a diagnostic value. However, both imaging and current single-analyte biomarkers exhibit substantial limitations in measuring the disease status and predicting the therapeutic efficacy. RECIST remains suboptimal as a metric. A critical unmet need is the development of a clinico-biological tool to provide enhanced information regarding precise disease status and treatment response. The group considered that circulating RNA was better than current general NEN biomarkers and preliminary clinical data were considered promising. It was resolved that circulating multianalyte mRNA (NETest) had clinical utility in both diagnosis and monitoring disease status and therapeutic efficacy. Overall, it was concluded that a combination of tumor spatial and functional imaging with circulating transcripts (mRNA) would represent the future strategy for real-time monitoring of disease progress and therapeutic efficacy.
AB - The complexity of the clinical management of neuroendocrine neoplasia (NEN) is exacerbated by limitations in imaging modalities and a paucity of clinically useful biomarkers. Limitations in currently available imaging modalities reflect difficulties in measuring an intrinsically indolent disease, resolution inadequacies and inter-/intra-facility device variability and that RECIST (Response Evaluation Criteria in Solid Tumors) criteria are not optimal for NEN. Limitations of currently used biomarkers are that they are secretory biomarkers (chromogranin A, serotonin, neuron-specific enolase and pancreastatin); monoanalyte measurements; and lack sensitivity, specificity and predictive capacity. None of them meet the NIH metrics for clinical usage. A multinational, multidisciplinary Delphi consensus meeting of NEN experts (n = 33) assessed current imaging strategies and biomarkers in NEN management. Consensus (>75%) was achieved for 78% of the 142 questions. The panel concluded that morphological imaging has a diagnostic value. However, both imaging and current single-analyte biomarkers exhibit substantial limitations in measuring the disease status and predicting the therapeutic efficacy. RECIST remains suboptimal as a metric. A critical unmet need is the development of a clinico-biological tool to provide enhanced information regarding precise disease status and treatment response. The group considered that circulating RNA was better than current general NEN biomarkers and preliminary clinical data were considered promising. It was resolved that circulating multianalyte mRNA (NETest) had clinical utility in both diagnosis and monitoring disease status and therapeutic efficacy. Overall, it was concluded that a combination of tumor spatial and functional imaging with circulating transcripts (mRNA) would represent the future strategy for real-time monitoring of disease progress and therapeutic efficacy.
KW - Journal Article
U2 - 10.1530/EC-16-0043
DO - 10.1530/EC-16-0043
M3 - Journal article
C2 - 27582247
VL - 5
SP - 174
EP - 187
JO - Endocrine Connections
JF - Endocrine Connections
SN - 2049-3614
IS - 5
ER -
ID: 179918185