Management of Advanced or Metastatic Atypical Lung Carcinoid with Disease Progression
Clinical scenario
This protocol addresses patients with advanced or metastatic atypical lung carcinoid — including
high-grade presentations — as well as those with significantly progressive carcinoid or who have
experienced progression after somatostatin analogue (SSA) therapy.
Who this applies to
The population includes patients with advanced or metastatic atypical carcinoid (including
high-grade disease), significantly progressive carcinoid, or disease that has progressed
following somatostatin analogue therapy — a well-defined escalation scenario in pulmonary
neuroendocrine tumor management.
Approach (partial overview)
For eligible patients in this setting, the structured regimen involves radionuclide-based
targeted therapy — dependent on somatostatin receptor imaging findings — or
immunomodulatory therapy as an alternative approach.
Full eligibility criteria, sequencing, and regimen detail available via the protocol →
References
DOI: 10.1016/j.annonc.2021.01.003
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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] (see Supplementary Material, available at https://doi.org/10.1016/j.annonc.2021.01.003 for detailed LUNA trial data).
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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]
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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]
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