51-gene neuroendocrine tumor mRNA signature (NETest) (NETest)

The 51-gene neuroendocrine tumor mRNA signature, widely known as the NETest, is a comprehensive liquid biopsy panel used for the clinical management of neuroendocrine tumors (NETs). Unlike traditional single-analyte biomarkers such as Chromogranin A, the NETest measures the simultaneous expression of 51 distinct mRNA transcripts in the blood that reflect the complex biological landscape of NETs, including pathways related to cell proliferation, signaling, and metabolic escape (Malczewska et al., 2020, PMID: 32306184). The test provides a quantitative score that correlates with tumor burden and disease progression, offering higher sensitivity and specificity than conventional imaging or protein biomarkers (Liu et al., 2019, PMID: 31203355). While not a therapeutic target itself, the NETest is used to monitor the efficacy of treatments such as somatostatin analogs (e.g., Octreotide) and peptide receptor radionuclide therapy (PRRT), as changes in the gene expression signature can predict treatment response or early disease recurrence. It is currently utilized to assist in the diagnosis, surgical follow-up, and therapeutic monitoring of various neuroendocrine malignancies, including those of the lung and gastrointestinal tract (Wren Laboratories, 2024).

Other names

51-gene blood transcript signatureNeuroendocrine tumor multigene blood testWren NETestNET-associated gene transcriptsCirculating NET mRNA panel

The NETest is a liquid biopsy diagnostic tool that utilizes real-time quantitative PCR (qPCR) to measure the expression levels of 51 specific mRNA transcripts in whole blood, which are then processed through a proprietary multianalytic algorithmic analysis to generate a score (0-100) representing tumor metabolic activity and disease status (Modlin et al., 2014, PMID: 24471573).