title: Consensus on biomarkers for neuroendocrine tumour disease.
abstract: 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.
authors.affiliation: Department of Medical Sciences, Endocrine Oncology, Uppsala University, Uppsala, Sweden.
authors.forename: Kjell
authors.initials: K
authors.lastname: Oberg
authors.affiliation: Yale University School of Medicine, New Haven CT, USA. Electronic address: imodlin@optonline.net.
authors.forename: Irvin M
authors.initials: IM
authors.lastname: Modlin
authors.affiliation: Section of Endocrinology, Department of Internal Medicine, Erasmus Medical Centre, Rotterdam, Netherlands.
authors.forename: Wouter
authors.initials: W
authors.lastname: De Herder
authors.affiliation: Charite Universitätsmedzin Berlin, Berlin, Germany.
authors.forename: Marianne
authors.initials: M
authors.lastname: Pavel
authors.affiliation: Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
authors.forename: David
authors.initials: D
authors.lastname: Klimstra
authors.affiliation: Imperial College London, Hammersmith Campus, London, UK.
authors.forename: Andrea
authors.initials: A
authors.lastname: Frilling
authors.affiliation: Division of Gastroenterology, University of Pennsylvania Health System, Philadelphia, PA, USA.
authors.forename: David C
authors.initials: DC
authors.lastname: Metz
authors.affiliation: Department of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
authors.forename: Anthony
authors.initials: A
authors.lastname: Heaney
authors.affiliation: Department of Nuclear Medicine, Erasmus Medical Centre, Rotterdam, Netherlands.
authors.forename: Dik
authors.initials: D
authors.lastname: Kwekkeboom
authors.affiliation: H Lee Moffitt Cancer Center, Tampa, FL, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Strosberg
authors.affiliation: University College London Cancer Institute, London, UK.
authors.forename: Timothy
authors.initials: T
authors.lastname: Meyer
authors.affiliation: Brown University, Liver Research Center, Providence, RI, USA.
authors.forename: Steven F
authors.initials: SF
authors.lastname: Moss
authors.affiliation: Department of Pathology, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Kay
authors.initials: K
authors.lastname: Washington
authors.affiliation: Markey Cancer Center, University of Kentucky, Lexington, KY, USA.
authors.forename: Edward
authors.initials: E
authors.lastname: Wolin
authors.affiliation: Department of Surgery, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Eric
authors.initials: E
authors.lastname: Liu
authors.affiliation: Department of Cell and Developmental Biology, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: James
authors.initials: J
authors.lastname: Goldenring
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood*; D003697:Delphi Technique; D006801:Humans; D035683:MicroRNAs / Q000097:blood; D054547:National Cancer Institute (U.S.); D009360:Neoplastic Cells, Circulating; D018358:Neuroendocrine Tumors / Q000097:blood* / Q000235:genetics* / Q000473:pathology; D011379:Prognosis; D014481:United States
chemical_list: D014408:Biomarkers, Tumor; D035683:MicroRNAs