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Throughout neuroendocrine tissue in the mammalian nervous system, gastrointestinal, and pulmonary tracks.ProGRP is secreted by neuroendocrine-type tumors such as small cell lung cancer (SCLC), medullary thyroid tumors, careinoids, and hormonal-resistant neuroendocrine-type prostate cancer.Sixty to seventy percent of SCLCs produce ProGRP.ProGRP has been routinely used as a tumor marker for SCLC in Japan for 10 years, and the first automated immunoassay for ProGRP has recently been made available.Dr.Ken Yamaguchi has shown that a chest x-ray plus ProGRP measurement can give a 97% positive predictive value for SCLC.Other groups have shown that ProGRP exhibits a sensitivity of 64.9% with a specificity of 96.5% for differentiating SCLC versus NSCLC.It has also been found to have the best sensitivity and specificity for detecting limited stage SCLC (AUC=0.929).ProGRP has shown to be useful in monitoring response to therapy, and is a reliable predictor of relapse and prognosis.ProGRP may also be useful in predicting therapy response to drugs that inhibit BCL-2.The genes for GRP and BCL-2 are located on the same chromosomal locus, and experiments are underway to determine if increase in serum proGRP correlates with an increase in BCL-2 copy and a response to BCL-2 antagonists.In summary, ProGRP is a useful marker for diagnosing and monitoring SCLC.