EpigenOMic Determinants of the Neuroendocrine Phenotype As Biomarkers for Neuroendocrine Neoplasms

For GEP mixed neuroendocrine (NE) non-neuroendocrine neoplasms (MiNENs) a key issue affecting prognosis is sometimes the difficulty in obtaining a timely diagnosis, as the NE component is often localized in deeper anatomical locations and/or becomes prevalent over time. The tissue material of biopsies may be not enough to define the NE component when this is particularly small and this could impact on therapeutic decision. Furthermore GEP NENs need to be characterized for potentially druggable biomarkers and liquid biopsy has clear advantage to the solid one to this aim. Here, we will exploit epigenetic differences characterizing NE tumors to build a DNA methylation-based liquid biopsy assay able to detect circulating tumor DNA of NE derivation, to enable the non-invasive diagnosis and monitoring of GEP-MiNENs.

Sex

All

Minimum age

18 Years

Inclusion Criteria:

* Patient with histologically confirmed diagnosis of NEC/MINEN amenable to surgery with radical intent
* Patient with histologically confirmed diagnosis of NET amenable to surgery with radical intent
* Patient with metastatic NET/NEC, amenable to biopsy or surgery, including palliative intent
* Patient histologically confirmed non-NEN histotype:

  1. Colorectal carcinoma
  2. Small intestine carcinoma
  3. Gastric or oesophageal carcinoma
  4. Pancreatic ductal adenocarcinoma
  5. Metastasectomy from any non-NEN GI carcinoma

Exclusion Criteria:

* Grading G1 and G2 \<=10% Ki67
* Presence of concomitant neoplasm (within 3 years)
* Concomitant major haematological alteration
* Concomitant major organ dysfunction (e.g. G3/4 liver or kidney failure)
* Ongoing chemotherapy