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Lancet Oncol. 2015 Sep;16(9):e435-e446. doi: 10.1016/S1470-2045(15)00186-2.

Consensus on biomarkers for neuroendocrine tumour disease.

Author information

Department of Medical Sciences, Endocrine Oncology, Uppsala University, Uppsala, Sweden.
Yale University School of Medicine, New Haven CT, USA. Electronic address:
Section of Endocrinology, Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, Netherlands.
Charite Universitätsmedzin Berlin, Berlin, Germany.
Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Imperial College London, Hammersmith Campus, London, UK.
Division of Gastroenterology, University of Pennsylvania Health System, Philadelphia, PA, USA.
Department of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
Department of Nuclear Medicine, Erasmus Medical Centre, Rotterdam, Netherlands.
H Lee Moffitt Cancer Center, Tampa, FL, USA.
University College London Cancer Institute, London, UK.
Brown University, Liver Research Center, Providence, RI, USA.
Department of Pathology, Vanderbilt University Medical Center, Nashville, TN, USA.
Markey Cancer Center, University of Kentucky, Lexington, KY, USA.
Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
Department of Cell and Developmental Biology, Vanderbilt University Medical Center, Nashville, TN, USA.


Management of neuroendocrine neoplasia represents a clinical challenge because of its late presentation, lack of treatment options, and limitations in present imaging modalities and biomarkers to guide management. Monoanalyte biomarkers have poor sensitivity, specificity, and predictive ability. A National Cancer Institute summit, held in 2007, on neuroendocrine tumours noted biomarker limitations to be a crucial unmet need in the management of neuroendocrine tumours. A multinational consensus meeting of multidisciplinary experts in neuroendocrine tumours assessed the use of current biomarkers and defined the perquisites for novel biomarkers via the Delphi method. Consensus (at >75%) was achieved for 88 (82%) of 107 assessment questions. The panel concluded that circulating multianalyte biomarkers provide the highest sensitivity and specificity necessary for minimum disease detection and that this type of biomarker had sufficient information to predict treatment effectiveness and prognosis. The panel also concluded that no monoanalyte biomarker of neuroendocrine tumours has yet fulfilled these criteria and there is insufficient information to support the clinical use of miRNA or circulating tumour cells as useful prognostic markers for this disease. The panel considered that trials measuring multianalytes (eg, neuroendocrine gene transcripts) should also identify how such information can optimise the management of patients with neuroendocrine tumours.

[Indexed for MEDLINE]
Free PMC Article

Conflict of interest statement

Declaration of interests KO has been an adviser for Novartis, Pfizer, Schering Plough, IPSEN, and Applied Accelerator Applications. IMM has been an adviser for Keewaydin Consulting Inc, Clifton Life Sciences, IPSEN, and Novartis, outside the submitted work. WDH has been on advisory boards for Novartis and IPSEN; and reports grants for clinical research and consultant fees from Novartis, IPSEN, and Lexicon, outside the submitted work. MP reports personal fees from Clifton Life Sciences, during the conduct of the study; grants from Novartis; and personal fees from Novartis, IPSEN, Pfizer, and Lexicon Pharmaceuticals, outside the submitted work. DCM reports personal fees from Clifton Life Sciences and Novartis, and reports grants for clinical research from IPSEN, Lexicon, and Applied Accelerator Applications. DKl reports personal fees from Wren Laboratories (during the study) and IPSEN (outside the submitted work. DKl owns stocks in Applied Accelerator Applications. JS reports personal fees from Clifton Life Sciences and Novartis, during the submitted work. TM reports advisory board fees from Novartis, Pfizer, Boeringer Inglheim, and Wren Laboratories and reports lecture fees from IPSEN. EW has been an adviser for Novartis. EL reports personal fees from Wren Laboratories, been part of the Speaker Bureau for Novartis, and been a consultant for IPSEN and received consultant fees from Novartis and IPSEN. JG reports personal fees from Wren Laboratories. All authors received reimbursement for travelling expenses to and from the neuroendocrine tumour consensus meeting in addition to an honorarium from Wren Laboratories. AF, AH, DKw, SFM, and KW declare no competing interests.

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