ASO Author Reflections: A Genomic Blood Test (NETest) that Informs you if the Patient has a Recurrence at the First Postoperative Visit

Excerpt

Tumor recurrence is a critical issue in curative oncological surgery, especially in neuroendocrine tumor (NET) surgery. Since the majority of NETs are metastatic at diagnosis, the opportunity to undertake a successful R0 surgery is especially important and recurrence is therefore a major setback. To date, the difficulty has been in the timely identification of recurrent disease. Current strategy comprises clinical assessment, imaging, and measurement of secretory biomarkers. Clinical evidence such as a mass or symptoms is often late and difficult to detect. Anatomic imaging [computed tomography/magnetic resonance imaging (CT/MRI)] is challenging to interpret postsurgery. Even specific techniques such as somatostatin receptor (SSTR)-based imaging are unreliable given the overexpression of SSTRs in healing tissue. Biomarkers are only useful in  a minority of NETs that secrete specific bioactive products such as insulin, gastrin, sertonin etc.1 The default pan-NET biomarker chromogranin A (CgA) is a secretory protein that is clinically ineffective (approximately 50% accurate) and is no longer recommended by guidelines;2 thus, early, accurate, and objective evidence of recurrent disease post surgery remains challenging. …