Pulmonary Neuroendocrine Tumors: Adjuvant and Systemic Treatments
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Neuroendocrine Cancers (JR Strosberg, Section Editor)
Pulmonary Neuroendocrine Tumors: Adjuvant and Systemic Treatments Dipesh Uprety, MD Thorvardur R. Halfdanarson, MD Julian R Molina, MD, PhD Konstantinos Leventakos, MD, PhD* Address * Division of Medical Oncology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA Email: [email protected]
* Springer Science+Business Media, LLC, part of Springer Nature 2020
This article is part of the Topical Collection on Neuroendocrine Cancers Keywords Adjuvant I Carcinoids I Lung I Neuroendocrine I Pulmonary I Systemic treatment
Opinion statement Bronchial carcinoids are uncommon tumors accounting for 20 to 30% of all neuroendocrine tumors and about 1–2% of all cancers of pulmonary origin. Bronchial carcinoids are well-differentiated neuroendocrine tumors and have a favorable survival outcome when compared with other subtypes of lung cancers. Treatment of bronchial carcinoids is not simple owing to intricacy of symptom presentation and heterogeneity of disease biology. Successful treatment of patients requires a multimodality approach. Resection is curative in the majority of patients with localized tumors and adjuvant treatment is not routinely recommended. Multiple options for systemic therapy exist for patients with advanced disease. To date, very few randomized clinical trials have been done, partly owing to the relative rarity of this malignancy. Somatostatin analogs (SSAs) are reasonable first-line choice for patients with tumors expressing somatostatin receptors. Everolimus is an appropriate first-line choice for somatostatin receptor negative tumors and for any patients with progressive disease. PRRT can also be considered for progressive tumors expressing somatostatin receptors. Based on retrospective series, cytotoxic chemotherapy can be selected in patients with progressive tumors, primarily when cytoreduction is needed. Herein, we will discuss evidence supporting the role of adjuvant and systemic treatment therapies for those with bronchial carcinoid tumors by focusing on various studies.
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Curr. Treat. Options in Oncol.
(2020) 21:86
Introduction Neuroendocrine tumors (NETs) are rare malignant tumors arising from the cells of neuroendocrine system. Bronchial NET, the most common site outside of the abdomen of NETs, represents about 20% of all bronchial cancers [1, 2]. These tumors include a spectrum of malignancies ranging from a low-grade typical carcinoid tumor (TC); an intermediate-grade atypical carcinoid tumor (AC); high-grade, poorly differentiated large cell neuroendocrine carcinoma; and a small-cell carcinoma.
There is an overall trend toward increasing incidence of these tumors in recent years [2–4], which may be partly related to increasing awareness and diagnostic accuracy, but also increasing use of imaging studies resulting in an increase in incidental diagnoses [5••]. In this review article, we will focus on adjuvant and systemic treatment options for the treatment of bronchial carcinoid. The term bronchial
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