Treatment of Advanced/Metastatic Thymic Carcinoid in Atypical or High-Grade Carcinoid and After SSA Progression

This protocol covers patients with advanced or metastatic carcinoid tumor of the thymus who present with atypical carcinoid histology (including high-grade), significant radiological progression, or disease that has progressed following somatostatin analogue (SSA) therapy.

Clinical Scenario

Advanced or metastatic thymic carcinoid with atypical carcinoid features — including high-grade tumors — or cases showing marked radiological progression, or progression after SSA therapy. The tumor's proliferative characteristics are a key factor in determining the appropriate treatment strategy.

Treatment Approach (Partial Overview)

Treatment in this setting involves targeted systemic therapy as a primary option, with chemotherapy-based regimens as alternatives; in tumors with high proliferative activity, the upfront strategy differs.

Full regimen, sequencing, and patient-selection criteria available in the complete protocol →

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.annonc.2021.01.003

Everolimus is considered as first-line therapy in the majority of ACs or following progression to SSA for both TC and AC patients [II, B]
Everolimus is recommended either as first line in case of AC or, second-line post-SSA, in patients with TC and or progressive advanced LCs and ThCs [II, B]
Upfront everolimus or dacarbazine/temozolomide-based or oxaliplatin-based ChT is recommended, or in selected subgroup PRRT (based on positive uptake at SRI on all RECIST-evaluable targets) in high proliferative ACs [V, C]

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