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

The NETest is a blood-based neuroendocrine cancer diagnostic that can be used to help diagnose, recommend treatment, and then monitor progress for neuroendocrine tumor (NET) or neuroendocrine neoplasia (NEN) patients in real-time.

Quick and non-invasive, results from this novel liquid biopsy can be shared within 48 hours of receiving a blood sample. Upon receipt at our CAP and CLIA-certified lab, we use a quantitative polymerase chain reaction (qPCR) method to measure the expression levels of 51 genes related to neuroendocrine cancer. We then employ our multianalyte algorithmic analyses (MAAA) to calculate the likelihood of a patient having a NET or NEN. We then share that likelihood or risk score with your oncologist. 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 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-review articles, clinical studies, and scientific journal entries. After a decade of study, and over 10,000 use cases in the US alone, the empirical evidence is clear: NETest outperforms all molecular and non-molecular biomarkers in neuroendocrine tumor diagnosis and management.

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 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.


10,000+ NETests Utilized

Prominent Oncologists Worldwide have recommended 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 a .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 from your physician and get your blood sample drawn at your local laboratory.


Sample Transportation

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



Testing is Performed

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


Results are Generated

Once the NETest result is produced and verified, it is sent to your doctor.



Clinician Analysis

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


Patient Update

Your doctor notifies you 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 a dangerous to talk about replacing something. Rather, our focus is 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.

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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. Superimpose 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.

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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.

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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. [DR KIDD WANTS TO DISCUSS THE FOLLOWING: So a molecular test that comes in at three to four thousand dollars a year is, whilst not cheap, in the context of what a disease costs and what that cost means to a patient’s life is a very economical consideration for the healthcare system.]

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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.

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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.

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How rare is the disease?

The incidents of NETs is about 8 per 100,000 persons. It occurs as frequently as testicular cancer, Hodgkin’s Disease, gliomas (brain tumors), and multiple myeloma. The general professional consensus is that because NETs present similarly to so many other health disorders, and, as such, result in misdiagnosis, the disease may not be as rare as previously thought.

Wren Labs & NETs

History of Wren and Neuroendocrine Tumors

This company was founded because Dr. Irvin Modlin, troubled by the post-surgical recurrence of Neuroendocrine Tumors, looked to genetic research to uncover NET biomarkers in blood samples. Oncologists now employ these insights about using mRNA to detect NETs, then recommend and monitor treatment. Learn more about the history of Wren Laboratories and the science behind our  molecular cancer diagnostics.