Neuroendocrine Tumors Clinical Trial
Official title:
Identification of Biomarker Profiles for Individualized Prognostic Stratification and Therapy in Patients With Gastroenteropancreatic Neuroendocrine Neoplasia (GEP-NEN)
Although gastroenteropancreatic neuroendocrine neoplasia (GEP-NEN) were considered for years
as rare tumors, their incidences are increasing. Due to their potential of early metastases
and their heterogenous response to therapy, these tumors are important clinical entities. A
major problem remains the impossibility to adequately predict tumors' response to treatment,
precluding an individualized therapy. Further, there is no method to efficiently screen
these tumors. Protein based analyses (proteomic analyses) gain in interest as methods to
address this problematic.
The present study was designed to investigate epidemiologic data of patients with GEP-NEN
and to answer following questions using proteomic analysis applied to existing pathology
specimens (paraffin-embedded specimens, FFPE): is it possible to explore protein signatures
in this type of tumors? Is the response to therapy predictable using specific protein
signatures? Is the tumor's tendency to metastasize related to specific protein signatures?
Gastroenteropancreatic neuroendocrine neoplasia (GEP-NEN) were considered for years as rare
tumors. In last years however, their incidences are increasing (3,65 / 100.000 / year)
[Lawrence et al., 2011; Friling et al, 2014]. These tumors are important clinical entities:
1) 40-95% of tumors have metastasized at diagnosis, 2) evidence-based data dealing with the
therapeutic strategy and screening are still scarce.
A central problem remains the impossibility to adequately predict the response to surgery,
chemotherapy, radiochemotherapy, peptid-receptor-based Radiotherapy or biotherapy,
precluding an individualized therapy (precision medicine) [Rinke et al., 2014]. An actual
research topic in these patients is the identification of patient markers allowing an
response prediction. Moreover, researchers try to identify tumor markers in patients with
unknown primary in order to locate the origin of metastases. Further, identification of
tumor specific markers would allow the development of screening strategies in GEP-NEN. Due
to the ability of these techniques to describe the biological heterogenity of a tumor,
proteomics (protein based analysis methods) are promising in the present problematic
[Bezabeh et al., 2014; Löhr et al., 2006; Pan et al., 2013].
The present study was designed to investigate epidemiologic data of patients with GEP-NEN
and to answer following questions using proteomic analysis (MALDI-MS) applied to existing
pathology specimens (paraffin-embedded specimens, FFPE): is it possible to explore protein
signatures in this type of tumors? Is the response to therapy predictable using specific
protein signatures? Is the tumor's tendency to metastasize related to specific protein
signatures? The present investigation explores the GEP-NEN database/register of following
institutions: University Hospital Schleswig Holstein, University hospital of Freiburg,
Agaplesion Hospital Rotenburg. The pathology specimens of the studied register-population,
were identified in the biobank and pathology-institutes of the participating hospitals and
investigated using MALDI-MS technique.
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Time Perspective: Retrospective
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