Evidence map›Paper›PMID 41212394›Full record

ArticleEndocrine pathology2025

Molecular Subtypes of Pancreatic Neuroendocrine Tumors Mutated in MEN1/DAXX/ATRX Explain Biological Variability.

Simona Avanthay, Annunziata Di Domenico, Philipp Kirchner, Konstantin Bräutigam, Aziz Chouchane, Renaud Maire, Christina Thirlwell, Corina Kim-Fuchs, Aurel Perren, Ilaria Marinoni

Erratum issuedAbstract read
In one paragraph

Article in Endocrine pathology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Review
  3. Review
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Simona AvanthayInstitute of Tissue Medicine and Pathology, University of Bern, Bern, 3008, Switzerland.ORCID http://orcid.org/0000-0001-8142-7919
Annunziata Di DomenicoInstitute of Tissue Medicine and Pathology, University of Bern, Bern, 3008, Switzerland.
Philipp KirchnerInstitute of Tissue Medicine and Pathology, University of Bern, Bern, 3008, Switzerland.ORCID http://orcid.org/0000-0002-7972-2318
Konstantin BräutigamInstitute of Tissue Medicine and Pathology, University of Bern, Bern, 3008, Switzerland.ORCID http://orcid.org/0000-0002-3966-3579
Aziz ChouchaneInstitute of Tissue Medicine and Pathology, University of Bern, Bern, 3008, Switzerland.ORCID http://orcid.org/0009-0001-8812-6788
Renaud MaireInstitute of Tissue Medicine and Pathology, University of Bern, Bern, 3008, Switzerland.
Christina ThirlwellBristol Medical School, University of Bristol, Bristol, England, UK.ORCID http://orcid.org/0000-0003-3962-5780
Corina Kim-FuchsDepartment of Visceral Surgery and Medicine, University Hospital Bern, University of Bern, Bern, Switzerland.
Aurel PerrenInstitute of Tissue Medicine and Pathology, University of Bern, Bern, 3008, Switzerland.ORCID http://orcid.org/0000-0002-6819-6092
Ilaria MarinoniInstitute of Tissue Medicine and Pathology, University of Bern, Bern, 3008, Switzerland. ilaria.marinoni@unibe.ch.ORCID http://orcid.org/0000-0003-1721-6636

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

About 40% of non-functioning (NF) Pancreatic Neuroendocrine Tumors (PanNETs) harbour mutations in MEN1, often co-occurring with DAXX/ATRX. While the ADM group (MEN1 and DAXX/ATRX co-mutated) exhibits homogeneous genetic and epigenetic features and a consistent risk of relapse, it shows considerable variability in treatment response, suggesting an underlying molecular diversity. In this study we aimed to elucidate the molecular mechanisms underlying this heterogeneity of ADM PanNETs by integrating transcriptomic (n = 36) and DNA methylation (n = 93) data. First, DNA methylation discriminates ADM-PanNET from PanNET mutated only in MEN1 (α-like), revealing enhancer, peri-centromeric, and telomeric methylation changes associated with alternative lengthening of telomeres and increased chromosomal instability. Transcriptomic analysis further revealed three distinct ADM subtypes: ADM hypoxic, ADM NST (No Special Type), and ADM immunosuppressive. The ADM hypoxic subtype is characterized by strong hypoxia signature, likely regulated epigenetically. The ADM NST subtype appears to be primarily driven by epigenetic changes that promote proliferation. Notably, the ADM immunosuppressive subtype, although significantly smaller (< 2.5 cm, p = 0.023), exhibits strong immune and metastasis-like signatures, suggesting a uniquely aggressive biology despite its reduced size. By defining these three novel ADM subtypes, our study provides a refined framework for understanding PanNET heterogeneity. This classification underscores potential diagnostic markers and highlights distinct biological vulnerabilities that may inform the development of subtype-tailored therapeutic strategies.

Indexed as

Co-Repressor ProteinsNeuroendocrine TumorsPancreatic NeoplasmsProto-Oncogene ProteinsX-linked Nuclear ProteinDNA MethylationFemaleHumansMaleMolecular ChaperonesMutationATRX protein, humanCo-Repressor ProteinsDAXX protein, humanMEN1 protein, humanMolecular ChaperonesProto-Oncogene ProteinsX-linked Nuclear ProteinEpigenomeNeuroendocrinePancreasTranscriptomeTumor

Identifiers

PMID41212394
PMCPMC12602606

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.