TY - JOUR
T1 - The role of multimodal treatment in patients with advanced lung neuroendocrine tumors
AU - Fazio, Nicola
AU - Ungaro, Antonio
AU - Spada, Francesca
AU - Cella, Chiara Alessandra
AU - Pisa, Eleonora
AU - Barberis, Massimo
AU - Grana, Chiara
AU - Zerini, Dario
AU - Bertani, Emilio
AU - Ribero, Dario
AU - Funicelli, Luigi
AU - Bonomo, Guido
AU - Ravizza, Davide
AU - Guarize, Juliana
AU - De Marinis, Filippo
AU - Petrella, Francesco
AU - Del Signore, Ester
AU - Pelosi, Giuseppe
AU - Spaggiari, Lorenzo
PY - 2017/11/1
Y1 - 2017/11/1
N2 - 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.
AB - 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.
KW - Atypical carcinoid (AC)
KW - Bronchopulmonary carcinoid
KW - Lung carcinoid
KW - Lung NET
KW - Typical carcinoid
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U2 - 10.21037/jtd.2017.06.14
DO - 10.21037/jtd.2017.06.14
M3 - Review article
AN - SCOPUS:85033489885
VL - 9
SP - S1501-S1510
JO - Journal of Thoracic Disease
JF - Journal of Thoracic Disease
SN - 2072-1439
ER -