The potential role of circulating DNA in the management of neuroendocrine tumors: NET Sanguis study

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Introduction: Pancreatic neuroendocrine tumors (PNETs) have variable biology, with no validated biomarkers to predict behaviour or treatment response. Circulating tumoral DNA (ctDNA) has been utilised in other cancers as a biomarker for mutation detection, drug target identification and direct change of therapy. ctDNA has been detected in patients with PNETs: its utility as a biomarker in the disease course of PNET patients has not been assessed.

Aim(s): To evaluate the associations of ctDNA with tumoral mutation profile, histological grade and PET imaging phenotype at baseline. To determine the associations of ctDNA with therapy response and survival.

Materials and methods: Observational/longitudinal in patients with PNETs, across 6 Australian NET Centres. Eligible patients include: (1) Diagnosis of PNET, (2) Grades 1 to 3, (3) Newly diagnosed or under active treatment: (a) Newly diagnosed: planned to undergo either: (i) Observation (ii) Systemic therapy; chemotherapy, MTA, SSA, or PRRT (b) Under active therapy, ≤ 2 lines of therapy. (4) Measurable/evaluable disease. Patients to have blood taken for ctDNA every 12 weeks for 96 weeks. Tumoral tissue at diagnosis & at progression will be analysed. Clinical data collected include: demographics, PNET pathology details, NET treatment, structural/PET staging. Germline DNA (peripheral blood mononuclear cells) will be sequenced in parallel with tumoral & ctDNA. The sample size is 100 patients.

Conference: 18th Annual ENETS Concerence (2021)

Presenting Author: Michael M

Authors: Michael M, Segelov E, Chan D, Wyld D, Price T,

Keywords: pancreatic neuroendocrine tumor, biomarker, circulating DNA,