A liquid biopsy neuroendocrine tumor diagnostic to help oncologists better manage NETs

The NETest is a blood-based neuroendocrine cancer diagnostic that aids in the diagnosis, treatment recommendation, and real-time progress monitoring of patients with neuroendocrine tumors (NET) or neuroendocrine neoplasia (NEN).

Quick and non-invasive, results from this novel liquid biopsy can be shared within 48 hours of receiving a blood sample. Once received at our CAP and CLIA-certified lab, we utilize a quantitative polymerase chain reaction (qPCR) method to measure the expression levels of 51 genes associated with neuroendocrine cancer. Subsequently, our multianalyte algorithmic analyses (MAAA) are employed to calculate the probability of a patient having a neuroendocrine tumor (NET) or neuroendocrine neoplasia (NEN). The obtained likelihood or risk score is then available. Learn more about Our Science.

The NETest, which has been used over 10,000 times in medical centers throughout the United States, delivers higher levels of sensitivity, specificity, and accuracy than any other testing method available today. It helps oncologists and patients better manage and monitor treatment and quickly detect the recurrence of disease.

NETest by the Numbers

Prior to and since its introduction in 2014, the NETest has been the subject of 63 peer-reviewed articles, clinical studies, and scientific journal entries. With over a decade of research and over 10,000 use cases in the US alone, the empirical evidence is clear: NETest outperforms all other molecular and non-molecular biomarkers in the diagnosis and management of neuroendocrine tumors.

98.4% sensitivity for prediction of NETs

NET PCR assay exhibits more than twice the sensitivity of chromogranin A (CgA) testing.


94% accuracy in PRRT response prediction

NETest PPQ significantly outperforms CgA in prediction response to Peptide Receptor Radionuclide Therapy.


99% post-treatment recurrence diagnostic accuracy

NETest reduces imaging requirements in almost half of patients.


86% accuracy in determining disease status

NETest clinical utility in differentiating stable vs progressive disease is unsurpassed.


The NETest PPQ

A Companion Diagnostic to predict PRRT Response

The PRRT Predictive Quotient, or PPQ, was developed to predict peptide receptor radionuclide therapy (PRRT) response in bronchopulmonary (BP-NETs) and gastroenteropancreatic (GP-NETs) neuroendocrine tumor patients.

Research has shown that PPQ, based on an algorithm that combines normalized gene expression from 8 targeted genes and the histological grade of the NET, can predict a GP-NET or BP-NET patient’s response to PRRT treatment with 96% accuracy.

PPQ Responders vs Non Responders

NETest levels correlate with PPQ prediction of PRRT response.  European Journal of Nuclear Medicine and Molecular Imaging, Sept, 2019

10,000+ NETests Utilized

Prominent Oncologists Worldwide have Recommended and Utilized the NETest

Since the first commercial sale of the NETest shortly after our founding in 2014, over 10,000 NETests have been used by doctors and oncologists affiliated with some of the most well-respected Cancer Centers across the United States. Visit our NETest Resources Page to learn more

View a Sample Test

Interested in seeing a sample lab report for the NETest, detailing test methodology, score calculation, and sample NETest results? Then click below to download the PDF.

Order NETest

Are you a doctor, or a patient working with a doctor or oncologist, and would like to order a NETest? Then click the link below for our online requisition.

Featured NETest Resources

The latest Peer-Reviewed Papers and News Coverage of the NETest

An interview with the Co-Inventor of the NETest

“The NETest fulfills a completely unmet need in neuroendocrine tumor disease: there have been no biomarkers that are effective or accurate. This is a multi-genomic test and it is about 95% accurate and 95% sensitive. It makes the diagnosis of neuroendocrine tumors, then allows you to monitor neuroendocrine tumors to see if the disease is stable or progressive.”

Dr. Irvin M. Modlin

Founder of Wren Laboratories and co-developer of the NETest


The NETest Testing Process



A Non-Invasive Blood Draw

Obtain a requisition in conjunction with your doctor, then get your blood sample drawn at a local laboratory.


Sample Transportation

The blood sample with the requisition form is sent overnight to the clinical testing laboratory at Wren Laboratories, Branford, CT.



Testing is Performed

The laboratory performs all testing necessary to generate a NETest result – a process that typically takes two full days.


Results are Generated

Once the resuls are  produced and verified, the NETest report is sent to your doctor.



Clinician Analysis

Your doctor interprets the NETest result in conjunction with other clinical assessments.


Patient Update

The patient is notified of the results.

Frequently Asked Questions

Your Questions Answered

We have received many questions about the NETest from oncologists and patients alike. Following are some answers provided by Dr. Modlin, Dr. Kidd, and other members of the Wren Team. 

Does NETest Replace or supplement imaging?

It’s dangerous to talk about replacing something. Rather, our focus is on how can we make information synergistic. So an image is important but an image only tells you the size of something. A NETest, which is based on 51 different genes which capture the entire biological activity, tells you how that tumor is likely to behave. When you compare the NETest head-to-head with imaging, you have patients that have had negative imaging for one, two, three, or four years, although the NETest is positive. So it’s 10 to 15 thousand times more sensitive. Nevertheless, it shouldn’t be looked at as a value positive or a value negative; it should be looked at as a value additive. We see it as imaging informed by molecular genomic information.

Watch Video

Is the NETest more effective than CgA tests?

The original test that was used for identifying neuroendocrine tumors and monitoring their behavior was chromogranin, also called CgA. It’s a mono analyte; it just measures a secretory component of the tumor cell. Secretion is of no value when looking at the proliferation or the outcome of a tumor. Superimposed upon that, CgA is a very technically unreliable test and only gives you one piece of information. In contrast, the NETest is a multigenomic; 51 different gene assays which give you the whole constellation (of the tumor). It is far more accurate, far more sensitive, and far more informative. It’s like ‘Why would you buy yourself a Model T Ford if you could get a Tesla?”

Watch Video

What is the NETest specificity and sensitivity?

The specificity of the NETest is about 95% and the sensitivity is pretty much the same. It’s the only biomarker for neuroendocrine tumors which vaguely reaches that level. The NIH cut-off for an acceptable clinical biomarker is 80%. No other biomarker for neuroendocrine tumor disease has ever reached that biomarker level until the development of the NETest.

Watch Video

Is the NETest cost prohibitive?

The question of costs for biomarker tests is always a complex one. The first thing you have to consider is what’s the cost of the test itself. As important, you have to consider the cost of not getting the test. The failure to adequately diagnose or manage a disease, particularly a neuroendocrine tumor disease, is about $100,000 to $150,000 a year.

Watch Video

When should you use the NETest?

One of the big difficulties with Neuroendocrine Tumor disease is diagnosing it and monitoring its progression. Imaging is relatively ineffective. So the NETest can firstly make the diagnosis of the tumor, secondly, if the tumor is resected it will instantly reflect if there is residual disease and then if the patient has been monitored, as everybody has to do in a post-operative phase, it will tell you if the disease is non-existent, stable or progressive. If therapy is applied, it will in fact tell you if the therapy is effective or not.

Watch Video

What is the importance of the NETest?

The NETest fulfills a completely unmet need in neuroendocrine tumor disease:  up until now, there have been no biomarkers that are effective or accurate. This is a multi-genomic test and it is about 95% accurate and 95% sensitive. It helps make the diagnosis of neuroendocrine tumors, it allows you to monitor neuroendocrine tumors to see if the disease is stable or progressive and it can be obtained by a single puncture of blood, put in a test tube, and mailed off to Wren Laboratories which is in Connecticut.

Watch Video

The History of Wren Labs & NETs

History of Wren and Neuroendocrine Tumors

Wren Laboratories was established when Dr. Irvin Modlin, concerned by the post-surgical recurrence of Neuroendocrine Tumors, turned to genetic research in search of NET biomarkers in blood samples

Oncologists now employ the insights garnered by using mRNA to detect NETs, and then recommend and monitor treatment. Learn more about the history of the NETest and our science.