In 40 neuroendocrine tumor patients who completed PRRT, VEGF-R1 levels decreased significantly after treatment and showed the best discriminatory ability (AUC 0.7) for identifying treatment responders among the angiogenic biomarkers tested.
VEGF-R1 AUC: 0.7Among five angiogenic biomarkers tested, VEGF-R1 showed the best ability to distinguish PRRT responders from non-responders in neuroendocrine tumor patients
What the researchers found
After four PRRT cycles in 40 NET patients, CgA, VEGF-R1, and VEGF-R2 decreased significantly while VEGF-R3 increased. VEGF levels were unchanged. VEGF-R1 had the best discriminatory value for treatment response (AUC 0.7).
Why it matters
PRRT uses radiolabeled somatostatin peptide analogs to target tumors, but predicting which patients will respond remains challenging. Identifying reliable blood biomarkers like VEGF-R1 could help clinicians monitor treatment effectiveness and potentially guide therapy decisions without waiting for imaging results.
The numbers in context
NETs are characterized by rich vascularization. PRRT uses radiolabeled peptides targeting somatostatin receptors.
How the study worked
Prospective cohort of 40 patients with gastro-entero-pancreatic and broncho-pulmonary neuroendocrine tumors who completed four cycles of PRRT. Serum CgA, VEGF, VEGF-R1, VEGF-R2, and VEGF-R3 measured by ELISA before and after treatment. AUROC analysis assessed biomarker discriminatory ability for treatment response.
Who was studied
Neuroendocrine tumor patients receiving PRRT
What this study cannot tell us
Small sample size (40 patients) limits statistical power and generalizability. Single-center study. AUC of 0.7 indicates only moderate discriminatory ability. No comparison to imaging-based response assessment. Mixed GEP and BP NET types may mask tumor-specific biomarker patterns.
How to read the evidence
Rated preliminary: small cohort of 40 patients with moderate discriminatory findings (AUC 0.7). Needs larger validation studies before clinical adoption.
When this study was published
Published in 2024. Represents current biomarker research in the peptide radionuclide therapy field.
The bigger picture
PRRT is a key peptide-based treatment for advanced neuroendocrine tumors, but monitoring tools are limited. This study adds VEGF-R1 to the list of potential response biomarkers, complementing traditional markers like chromogranin A and imaging. Better biomarkers could enable more personalized treatment approaches.
Questions still open
- Does combining VEGF-R1 with other biomarkers improve prediction of PRRT response beyond AUC 0.7?
- Are angiogenic biomarker changes different between GEP and broncho-pulmonary NETs?
- Could serial VEGF-R1 monitoring during PRRT cycles guide early therapy adjustments?
Common questions
What is PRRT and how does it treat neuroendocrine tumors?
Can a blood test tell if PRRT is working?
Read the original research
Angiogenic biomarkers of response to treatment with peptide receptor radionuclide therapy in neuroendocrine tumours.
Endokrynologia Polska, 75(4), 412-418
Citation
Strzelczyk, Janusz; Wójcik-Giertuga, Monika; Makulik, Karolina; Rosiek, Violetta; Kamiński, Grzegorz; Kajdaniuk, Dariusz; Kos-Kudła, Beata. (2024). Angiogenic biomarkers of response to treatment with peptide receptor radionuclide therapy in neuroendocrine tumours.. Endokrynologia Polska, 75(4), 412-418. https://doi.org/10.5603/ep.100241