This protocol addresses the management of carcinoid tumor of thymus in patients presenting with advanced or metastatic disease — specifically atypical carcinoid (including high-grade histology), cases with significant radiological progression, or disease progressing after somatostatin analogue (SSA) therapy.
The target population includes patients with advanced or metastatic thymic carcinoid of atypical histology — encompassing high-grade variants — as well as those with documented significant radiological progression or progression following SSA therapy. For atypical carcinoid (AC) patients, this population overlaps with those for whom everolimus represents a recognized first-line systemic option, or who have progressed on it.
In selected patients with confirmed adequate somatostatin receptor uptake on functional imaging, peptide receptor radionuclide therapy is among the options addressed by this protocol. Additional systemic strategies are also covered. The complete regimen — including selection criteria, sequencing, and all therapeutic options — is available in the full protocol.
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]
PRRT (based on positive uptake at SRI on all RECIST-evaluable targets) as alternative second-line (in case of uncontrolled CS) or mainly third-line therapy (beyond SSAs and or everolimus) in morphologically progressive or high tumour burden advanced LC and ThCs is recommended [IV, B]
IFN-a as a potential second-line (in case of uncontrolled CS) or mainly third-line alternative (beyond SSAs and or everolimus) is recommended in morphologically progressive or high tumour burden advanced LC and ThCs [IV, B]
Among platinum-based agents, oxaliplatin-based ChT is recommended by the majority of the panel [IV, C].
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