Treatment of advanced or metastatic atypical lung carcinoid, including significantly progressive and post-somatostatin analogue disease

This protocol addresses the management of pulmonary neuroendocrine tumors in patients presenting with advanced or metastatic atypical lung carcinoid — including high-grade cases — as well as those with significantly progressive disease or carcinoid that has progressed following somatostatin analogue therapy.

Clinical scenario

Advanced or metastatic atypical lung carcinoid (including high-grade), significantly progressive carcinoid, or disease that has progressed after somatostatin analogue therapy. These situations call for a structured, evidence-based treatment approach.

Treatment approach

For this scenario, targeted therapy plays a central role as a first-line option in atypical carcinoid, with cytotoxic chemotherapy representing an alternative strategy in select patients.

Complete regimen details, sequencing, and eligibility criteria are in the full 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].

Dacarbazine/temozolomide-based ChT as first line, and platinum-based ChT as second line, are recommended in advanced LC patients refractory or intolerant to everolimus therapy [IV, C].

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