Selection of chemotherapy in advanced poorly differentiated extra-pulmonary neuroendocrine carcinoma
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cancers-15-04951-v2-Weaver-Hub ...
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The Christie NHS Foundation Trust, University of Manchester, Wilmslow Road, Manchester M20 4BX, UK. Division of Cancer Sciences, School of Medical Sciences, University of Manchester, Manchester M20 4BX, UK.Issue Date
2023
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Extra-pulmonary poorly differentiated neuroendocrine carcinoma is rare, and evidence for treatment has been limited. In this article, the evidence behind the cytotoxic chemotherapy choices used for metastatic or unresectable EP-PD-NEC is reviewed. In the first-line setting, etoposide and platinum chemotherapy or irinotecan and platinum have been demonstrated to be equivalent in a large phase III trial. Questions remain regarding the optimal number of cycles, mode of delivery, and the precise definition of platinum resistance in this setting. In the second-line setting, FOLFIRI has emerged as an option, with randomized phase 2 trials demonstrating modest, but significant, response rates. Beyond this, data are extremely limited, and several regimens have been used. Heterogeneity in biological behaviour is a major barrier to optimal EP-PD-NEC management. Available data support the potential role of the Ki-67 index as a predictive biomarker for chemotherapy response. A more personalised approach to management in future studies will be essential, and comprehensive multi-omic approaches are required to understand tumour somatic genetic changes in relation to their effects on the surrounding microenvironment.Citation
Weaver JMJ, Hubner RA, Valle JW, McNamara MG. Selection of Chemotherapy in Advanced Poorly Differentiated Extra-Pulmonary Neuroendocrine Carcinoma. Cancers (Basel). 2023 Oct 11;15(20). PubMed PMID: 37894318. Pubmed Central PMCID: PMC10604995. Epub 2023/10/28. eng.Journal
Cancers (Basel)DOI
10.3390/cancers15204951PubMed ID
37894318Type
Articleae974a485f413a2113503eed53cd6c53
10.3390/cancers15204951
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