The role of multimodal treatment in patients with advanced lung neuroendocrine tumors

Nicola Fazio, Antonio Ungaro, Francesca Spada, Chiara Alessandra Cella, Eleonora Pisa, Massimo Barberis, Chiara Grana, Dario Zerini, Emilio Bertani, Dario Ribero, Luigi Funicelli, Guido Bonomo, Davide Ravizza, Juliana Guarize, Filippo De Marinis, Francesco Petrella, Ester Del Signore, Giuseppe Pelosi, Lorenzo Spaggiari

Research output: Contribution to journalReview articlepeer-review


Lung neuroendocrine tumors (NETs) comprise typical (TC) and atypical carcinoids (AC). They represent the well differentiated (WD) or low/intermediate grade forms of lung neuroendocrine neoplasms (NENs). Unlike the lung poorly differentiated NENs, that are usually treated with chemotherapy, lung NETs can be managed with several different therapies, making a multidisciplinary interaction a key point. We critically discussed the multimodal clinical management of patients with advanced lung NETs. Provided that no therapeutic algorithm has been validate so far, each clinical case should be discussed within a NEN-dedicated multidisciplinary team. Among the systemic therapies available for metastatic lung NETs everolimus is the only approved drug, on the basis of the results of the phase III RADIANT-4 trial. Another phase III trial, the SPINET, is ongoing comparing lanreotide with placebo. Peptide receptor radionuclide therapy and chemotherapy were not studied within phase III trials for lung NETs, and they have been reported to be active within retrospective or phase II prospective studies. Temozolomide and oxaliplatin are two interesting chemotherapeutic agents in lung NETs. While some European Institutions were certificated as Centers of Excellence for gastroenteropancreatic NENs by the European Neuroendocrine Tumor Society (ENETS), an equivalent ENETS certification for lung NENs does not exist yet. Ideally a lung NEN-dedicated multidisciplinary tumor board should include NEN-dedicated medical oncologists, thoracic medical oncologist, thoracic surgeons, pathologists, interventional radiologists, endocrinologists, radiotherapists, interventional pneumologists, nuclear physician.

Original languageEnglish
Pages (from-to)S1501-S1510
JournalJournal of Thoracic Disease
Publication statusPublished - Nov 1 2017


  • Atypical carcinoid (AC)
  • Bronchopulmonary carcinoid
  • Lung carcinoid
  • Lung NET
  • Typical carcinoid

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine


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