E-Mail karger@karger.com At the Cutting Edge Neuroendocrinology 2013;98:16–30 DOI: 10.1159/000348832 Improving the Diagnosis and Management of Neuroendocrine Tumors: Utilizing New Advances in Biomarker and Molecular Imaging Science Valeria Giandomenico a Irvin M. Modlin b Fredrik Pontén c Mats Nilsson d Ulf Landegren d Jonas Bergqvist e Mohid S. Khan f Robert P. Millar g Bengt Långström h Jürgen Borlak i Barbro Eriksson j Bengt Nielsen k Lars Baltzer h John C. Waterton l Håkan Ahlström m Kjell Öberg n a Department of Medical Sciences, Endocrine Oncology, University Hospital, Uppsala, Sweden; b Gastrointestinal Pathobiology Research Group, School of Medicine, Yale University, New Haven, Conn., USA; c Swedish Human Proteome Resource Project, d Rudbeck Laboratory, Department of Immunology, Genetics and Pathology, and e Analytical Chemistry and Neurochemistry, Biomedical Center, Uppsala University, Uppsala, Sweden; f Royal Free Hospital Neuroendocrine Tumor Unit, University College London, London, and g Human Reproductive Sciences Unit, MRC, University of Edinburgh, Edinburgh, UK; h Department of Biochemistry and Organic Chemistry, Uppsala University, Uppsala, Sweden; i Center of Drug Research and Molecular Pharmacology, Fraunhofer Institute of Toxicology and Experimental Medicine, Hannover, Germany; j Department of Endocrine Oncology, Center of Excellence, University Hospital, Uppsala, and k Academic Program, GE Healthcare International Research Division, Stockholm, Sweden; l Translational Sciences, AstraZeneca, and Biomedical Imaging Institute, University of Manchester, Manchester, UK; m Department of Oncology, Radiology and Clinical Immunology, and n Department of Endocrine Oncology, Center of Excellence, Endocrine Tumors, Uppsala University, Uppsala, Sweden lecular imaging technologies in patient diagnosis and follow- up has the potential to enhance care. To discuss develop- ments and issues required to improve diagnostics and man- agement of NET patients, with specific focus on the latest advances in molecular imaging and biomarker science, 17 global leaders in the fields of NET, molecular imaging and bio- marker technology gathered to participate in a 2-day meet- ing hosted by Prof. Kjell Öberg at the University of Uppsala in Sweden. During this time, findings were presented regarding methods with potential prognostic and treatment applica- tions in NET or other types of cancers. This paper describes the symposium presentations and resulting discussions. Copyright © 2013 S. Karger AG, Basel Key Words Biomarkers · Circulating tumor cells · Molecular imaging · Neuroendocrine tumors Abstract Neuroendocrine tumors (NET) are malignant solid tumors that arise in hormone-secreting tissue of the diffuse neuroen- docrine system or endocrine glands. Although traditionally understood to be a rare disease, the incidence and preva- lence of NET have increased greatly in the past 3 decades. However, during this time, progress in diagnosis and out- come of NET has generally been modest. In order to achieve improved outcome in NET, a better understanding of NET bi- ology combined with more reliable serum markers and better techniques to identify tumor localization and small lesions are needed. Although some NET biomarkers exist, sensitive and specific markers that predict tumor growth and behavior are generally lacking. In addition, the integration of new mo- Received: August 20, 2012 Accepted after revision: February 11, 2013 Published online: June 28, 2013 Kjell Öberg Department of Endocrine Oncology University Hospital, Entrance 40, 5th floor SE–75185 Uppsala (Sweden) E-Mail kjell.oberg  @  medsci.uu.se © 2013 S. Karger AG, Basel 0028–3835/13/0981–0016$38.00/0 www.karger.com/nen U.L. is one of the founders of and holds stock in Olink Bioscience AB, commercializing the proximity ligation and padlock technologies. K.Ö. has received speaker’s honoraria from Pfizer, Novartis and IPSEN and consulting fees from their advisory boards.