Metabonomics in NETs · Evolving landscape of neuroendocrine tumor disease: Predicting tumor behaviour using metabolic profiling

Background: Tumors that arise from neuroendocrine cells (NENs) were traditionally considered rare tumors with low malignant potential. Recent data suggest that the incidence of NENs has increased over the last three decades. Furthermore, symptoms are frequently overlooked and subsequently, 60-80% of these tumors present with metastases at initial diagnosis. The common denominator of these tumors is their neuroendocrine origin; however, they demonstrate remarkable diversity, unique properties and different survival rates. We have little knowledge regarding the fundamental regulators of proliferation of these tumors and, hence, we have a narrow range of treatment options. We need additional biological and molecular data to enhance our knowledge on NENs, optimize patient stratification according to prognosis and to develop a more successful treatment strategy. Metabonomics is an emerging research field that provides an insight into the metabolic pathways of living cells. It represents a promising tool for better understanding of genetic data, for establishing a “metabolic signature” and for interpreting epidemiology in the cell level by metabolic screening.Aim: The aim of this study is to develop a metabolic signature of NENs that would allow stratification according to the primary tumor site and the malignant potential. We will also try to investigate the reported increase of NENs incidence.Methods: Patients with neuroendocrine tumors will be included in the study. Spectroscopy and spectrometry techniques will be used for the development of a metabonomic profile.Relevance to the work programme: This project will allow the experienced researcher to attain a higher level of training in the management of NENs and to be exposed to the field of metabonomics. The expected impact of the acquired additional skills and knowledge for the researcher is to enhance his academic profile and strengthen his ability to obtain an academic post in the country of his origin.