Circulating neuroendocrine tumors biomarkers. Why? When? How? Suggestions for clinical practice from guidelines and consensus

Circulating neuroendocrine tumors biomarkers. Why? When? How? Suggestions for clinical practice from guidelines and consensus Paola Razzore1, Giorgio Arnaldi2 1SC Endocrinologia, AO Ordine Mauriziano, 10128 Turin, Italy. 2Clinica di Endocrinologia e Malattie del Metabolismo, AOU Ospedali Riuniti, 60100 Ancona, Italy. Corresponding Author: Dr. Paola Razzore, SC Endocrinologia, AO Ordine Mauriziano, Largo Turati 62, 10128 Torino, Italy. E-mail: razzorepaola@hotmail.com Neuroendocrine neoplasms (NETs) are rare tumors that are increasing in incidence. NETs are characterized by heterogeneous biological behaviour, clinical presentation and course. A sensitive and specific diagnostic and prognostic circulating biomarker useful for all sites, grading and staging of neuroendocrine tumors is still an unmet need. The aim of this article was to review current neuroendocrine and oncologic scientific society guidelines and position statements, and propose recommendations for the most frequent clinical practice queries on circulating neuroendocrine tumors biomarkers. The authors searched for NCCN, NANETS, ESMO, ENETS, UKINETS, AME management guidelines or position statements available from PubMed up to 7th January 2016. From these results we chose guidelines or position statements published by scientific societies or institutions in USA, Europe and Italy with recognized expertise in neuroendocrine tumor patient management. The authors present suggestions for clinical practice based on this analysis.