Chromogranin A, despite a number of limitations, is still the most valuable marker of neuroendocrine tumors (NETs). Granins belong to the family of acidic proteins that constitute a major component of secretory granules of various endocrine and neuroendocrine cells, which are components of both...

Neuroendocrine tumors are a heterogeneous group of neoplasms originating from the diffuse endocrine system. Depending on primary location and hormonal status, they range in terms of clinical presentation, prognosis and treatment. Functional tumors often develop symptoms indicating an excess of hormones produced by the neoplasm (exempli gratia insulinoma, glucagonoma and VIPoma) and can be diagnosed using monoanalytes. For non-functional tumors (inactive or producing insignificant amounts of hormones), universal biomarkers have not been established. The matter remains an important unmet need in the field of neuroendocrine tumors. Substances researched over the years, such as chromogranin A and neuron-specific enolase, lack the desired sensitivity and specificity. In recent years, the potential use of Circulating Tumor Cells or multianalytes such as a circulating microRNA and NETest have been widely discussed. They offer superior diagnostic parameters in comparison to traditional biomarkers and depict disease status in a more comprehensive way. Despite a lot of promise, no international standards have yet been developed regarding their routine use and clinical application. In this literature review, we describe the analytes used over the years and cover novel biomarkers that could find a use in the future. We discuss their pros and cons while showcasing recent advances in the field of neuroendocrine tumor biomarkers.

Gastroenteropancreatic neuroendocrine tumors (GEP/NET) are unusual and relatively rare neoplasms that present many clinical challenges. They characteristically synthesize, store and secrete a variety of peptides and neuroamines which can lead to the development of distinct clinical syndromes,...

Purpose. The peptide receptor radionuclide therapy (PRRT) is a treatment option for patients with disseminated, inoperable G1 and G2 neuroendocrine tumours (NETs). The study aims to evaluate the safety, efficacy, and progression-free survival (PFS) of patients after retreatment (R-PRRT) and re-retreatment (RR-PRRT) with tandem isotopes [⁹⁰Y]Y/[¹⁷⁷Lu]Lu-DOTATATE. Material and Methods. Out of 99 treated patients with G1 and G2 NETs, 26 were included in the study and treated with the repeated PRRT (with 5 undergoing the re-repeated PRRT treatment) after an initial positive response to four PRRT cycles and later progression of the disease. [⁶⁸Ga]Ga-DOTATATE PET/CT and CT/MRI procedures were performed before and after the treatment. Patients were treated with [⁹⁰Y]Y/[¹⁷⁷Lu]Lu-DOTATATE (1:1) with mixed amino acid infusion for kidney protection. Toxicity was evaluated using the CTCAE 3.0 criteria. Results. The median follow-up was 88 months (the range: 42164). The median cumulative administered activity was 22.2GBq (the range: 17.830.7GBq). Myelodysplastic syndrome occurred in one patient (3.8), and grade 4 renal toxicity was also detected in one patient (3.8). No other cases of grade 3 or 4 bone marrow and renal toxicity were observed. The median PFS rate was 31 months after the PRRT and 23 months following the R-PRRT. The OS rate from the diagnosis (OS-d) was 109 months and from the start of the PRRT (OS-t)-92.4 months. During the restaging, 36 months after the PRRT, PR, SD, and PD were observed in 19.2, 80.8, and 0 of the patients, respectively. After the R-PRRT, PR, SD, and PD were observed in 50, 42.3, and 7.7 of the patients, respectively. Conclusions. The repeated therapy with [⁹⁰Y]Y/[¹⁷⁷Lu]Lu-DOTATATE is safe and effective for patients with disseminated, inoperable G1 and G2 neuroendocrine tumours.

Background/Objectives: Increased dietary antioxidant capacity is a good means of lowering oxidative stress and cardiovascular risk. Established antioxidant capacity doses should be tested using dietary intervention. Methods: We analysed the influence of a high-antioxidant-capacity diet on oxidative stress (OS) and inflammatory and lipid profile in CVD (cardiovascular disease) subjects with initially low (LowA) and high (HighA) antioxidant capacity markers. It was an experimental study with a 6-week dietary intervention (DI). Forty-eight CVD patients completed the DI. Blood and urine samples were collected, and anthropometric measurements were taken. Dietary data were collected using a multi-day food record method. α-tocopherol, β-carotene, and retinol were chosen as antioxidant capacity markers; F2-isoprostanes (F2-IsoP), oxidised low-density lipoproteins (oxLDL), and uric acid (UA) were used as OS markers; and interleukin 6 (IL-6) and high-sensitivity C-reactive proteins (hs-CRP) were used as inflammatory markers. Total cholesterol, low- and high-density lipoproteins, and triglycerides (TCHOL, LDL, HDL, TRI) as lipid profiles were analysed. Two groups of subjects with LowA and HighA profiles were identified. Results: The total dietary antioxidant capacity intake during DI was increased by 56%. In the total sample, the DI increased β-carotene, retinol, and UA, and decreased IL-6 oxLDL. The LowA group exhibited increased β-carotene, α-tocopherol, retinol, and decreased IL-6. The HighA group exhibited increased β-carotene and decreased IL-6, F2-IsoP, oxLDL, and oxLDL/LDL ratio. In the HighA group, compared to the LowA group, greater decreases in α-tocopherol and F2-IsoP were found. In both groups, inflammatory markers (IL-6) decreased, and β-carotene increased. Conclusions: The DI results depended on the antioxidant capacity profile at baseline; nevertheless, the established DI including selected antioxidative snacks significantly decrease oxidative stress and improve antioxidant capacity. Further research on diet natural antioxidant supplementation needs to be continued.