Metabonomics to improve cancer care
Neuroendocrine tumours (NETs) emerge from cells in the endocrine and nervous systems, mainly from either the pancreas or the small bowel. The majority of NETs are diagnosed too late, when they have already metastasised. An additional problem with NETs is the scarcity of evidence-based practice strategies, which goes in hand with the lack of a sensitive and specific set of biomarkers. Seeking to address this need, scientists on the EU-funded METABONOMICS IN NETS project performed metabonomic analyses on samples from patients with different types of NETs. The idea was to evaluate how cancer is associated with perturbed metabolic responses and obtain data on a series of interacting metabolic networks. Scientists applied a metabolic phenotyping approach to the analysis of NETs to evaluate its clinical utility for improved diagnosis and as a response to treatment. This profiling was initially performed in urine samples from NET patients and normal subjects, demonstrating its ability to discriminate between healthy and cancer groups as well as between pancreatic and small bowel NET sub-types. Metabolites were measured using analytical platforms such as nuclear magnetic resonance spectroscopy and mass spectrometry. Project data were utilised to develop a robust and reproducible metabonomic signature with the potential to serve as a novel biomarker for NETs. This innovative approach should outperform chromogranin A, which is currently used for the diagnosis of NETs. Routine profiling of patient metabolites should offer a useful reference framework for novel diagnostics and targeting treatment modalities. Implementing metabonomics for NETs should also allow patient stratification and prognosis, leading to the identification of poor responders to treatment or those with poor prognosis. Offering alternative or intensified treatment options will improve the overall personalised health care of NET patients.
Keywords
Metabonomics, cancer, neuroendocrine tumours, biomarkers, metabolic phenotyping
