% IMPORTANT: The following is UTF-8 encoded. This means that in the presence % of non-ASCII characters, it will not work with BibTeX 0.99 or older. % Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or % “biber”. @ARTICLE{Schmitt:300176, author = {M. Schmitt and H. Bohnenberger and D. K. Bartsch and D.-C. Wagner and A.-S. Litmeyer and A. Grass and A. Rinke and C. Koch and M. Kremer and M. Evert and B. Märkl and A. Quaas and M. Eckstein and K. Steinestel and C. Denkert and K. Steiger and G. Klöppel and A. Kasajima and M. Tschurtschenthaler$^*$ and S. Foersch and M. Jesinghaus}, title = {{DLL}3 {E}xpression in {N}euroendocrine {C}arcinomas and {N}euroendocrine {T}umours: {I}nsights {F}rom a {M}ulticentric {C}ohort of 1294 {P}ulmonary and {E}xtrapulmonary {N}euroendocrine {N}eoplasms.}, journal = {Endocrine pathology}, volume = {36}, number = {1}, issn = {1046-3976}, address = {New York, NY}, publisher = {Springer}, reportid = {DKFZ-2025-00653}, pages = {9}, year = {2025}, abstract = {Delta-like ligand 3 (DLL3) is frequently expressed in pulmonary small cell neuroendocrine carcinoma (SCNEC) and has emerged as a promising therapeutic target. However, limited data on DLL3 expression in other neuroendocrine neoplasms (NEN), such as extrapulmonary SCNEC, large cell neuroendocrine carcinomas (LCNEC), mixed neuroendocrine-non-neuroendocrine neoplasms (MiNEN), gastroenteropancreatic neuroendocrine tumours (GEP-NET), and pulmonary carcinoids, impedes an estimation if other types of NEN might be suitable candidates for anti-DLL3 therapies. We evaluated DLL3 expression in 1294 NEN and 479 non-neuroendocrine carcinomas, correlating the findings with histological subtypes, tumour localisation, and overall survival (OS). Furthermore, we explored the concordance of DLL3 expression during metastatic progression in 67 paired primary NEN and metastases. DLL3 expression was significantly higher in NEC $(64.0\%)$ compared to GEP-NET and pulmonary carcinoids $(10.1\%,$ p < 0.001), particularly in SCNEC $(80.4\%),$ followed by LCNEC $(62.6\%)$ and MiNEN $(28.6\%).$ DLL3 was common in pulmonary carcinoids $(41.5\%),$ but rare in GEP-NET $(5.1\%)$ and non-neuroendocrine carcinomas $(1.3\%).$ Overall DLL3 expression was highly concordant between metastases and corresponding primary NEN $(92.5\%,$ p < 0.001). In univariable analyses, DLL3-expressing pulmonary carcinoids (p = 0.005) and GEP-NET (p = 0.018) were associated with decreased OS, but this was not retained in multivariable analyses adjusting for stage and grade (p = n. s.). No prognostic impact was observed in pulmonary (p = 0.708) or GEP-NEC (p = 0.87). Our study highlights significant differences in DLL3 expression across NEN subtypes and localisations, with largely concordant expression in metastases. DLL3-based therapies may be effective in many NEC and pulmonary carcinoids, while DLL3 appears to be a minor therapeutic target for GEP-NET and non-neuroendocrine carcinomas.}, keywords = {Humans / Neuroendocrine Tumors: pathology / Neuroendocrine Tumors: metabolism / Neuroendocrine Tumors: mortality / Carcinoma, Neuroendocrine: pathology / Carcinoma, Neuroendocrine: metabolism / Carcinoma, Neuroendocrine: mortality / Lung Neoplasms: pathology / Lung Neoplasms: metabolism / Male / Female / Intracellular Signaling Peptides and Proteins: metabolism / Intracellular Signaling Peptides and Proteins: biosynthesis / Middle Aged / Aged / Membrane Proteins: metabolism / Membrane Proteins: biosynthesis / Biomarkers, Tumor: analysis / Biomarkers, Tumor: metabolism / Adult / Cohort Studies / Aged, 80 and over / DLL3 (Other) / Neuroendocrine carcinoma (Other) / Neuroendocrine neoplasms (Other) / Neuroendocrine tumour (Other) / DLL3 protein, human (NLM Chemicals) / Intracellular Signaling Peptides and Proteins (NLM Chemicals) / Membrane Proteins (NLM Chemicals) / Biomarkers, Tumor (NLM Chemicals)}, cin = {MU01}, ddc = {610}, cid = {I:(DE-He78)MU01-20160331}, pnm = {899 - ohne Topic (POF4-899)}, pid = {G:(DE-HGF)POF4-899}, typ = {PUB:(DE-HGF)16}, pubmed = {pmid:40153138}, doi = {10.1007/s12022-025-09854-3}, url = {https://inrepo02.dkfz.de/record/300176}, }