This protocol applies to patients with advanced or metastatic typical lung carcinoid, or those with slowly progressing lung carcinoid that shows positive uptake on somatostatin receptor imaging (SRI). This specific presentation calls for a structured, stepwise treatment approach that accounts for tumour burden, progression pace, and receptor status.

Clinical Scenario

The population addressed here includes patients with advanced or metastatic typical lung carcinoid and, equally, those with slowly radiologically progressing lung carcinoid whose disease is positive on somatostatin receptor imaging. Watchful follow-up may also be appropriate in selected asymptomatic, slowly progressing cases.

Treatment Approach (Partial Overview)

When systemic therapy is required, platinum-based chemotherapy — with an oxaliplatin-based regimen favoured by the expert panel — represents one established chemotherapy option. Beyond this, additional later-line therapeutic strategies are available for patients with progressive or high-burden disease. The complete treatment sequence, full eligibility criteria, and all recommended options are detailed in the structured protocol.

References

SSAs are recommended first-line treatment in patients with TC and/or slowly progressing advanced SRI-positive LC and ThC [IV, C]
Watchful follow-up may be considered in asymptomatic patients with slowly radiologically progressing LCs [V, C]
Among platinum-based agents, oxaliplatin-based ChT is recommended by the majority of the panel [IV, C].
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]

DOI: 10.1016/j.annonc.2021.01.003

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Treatment of Advanced or Metastatic Typical Lung Carcinoid and Slowly Progressing SRI-Positive Lung Carcinoid

Clinical Scenario

Treatment Approach (Partial Overview)

References