Large cell neuroendocrine carcinoma of the lung with atypical evolution and a remarkable response to lutetium Lu 177 dotatate

Cornejo, R.A. Escala; García-Talavera, P.; Martín, Miguel; López, Berta Pérez; Muñoz, María García; Alonso, Ma Pilar Tamayo; Hernández, Juan Jesús Cruz

doi:10.1007/s12149-018-1276-6

Cited by 9 publications

(3 citation statements)

References 11 publications

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“…Their efficacy in LCNEC is yet to be determined. Case reports described a good response to PRRT in patients diagnosed with pulmonary LCNEC with positive somatostatin receptor scintigraphy [ 49 ].…”

Section: Role Of Targeted Therapymentioning

confidence: 99%

The Unmet Diagnostic and Treatment Needs in Large Cell Neuroendocrine Carcinoma of the Lung

Buium,

Negru,

Ionescu

et al. 2023

Current Oncology

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Large cell neuroendocrine carcinoma of the lung (LCNEC) is currently classified as a rare lung cancer subtype, but given the high incidence of lung cancer, the overall number of cases is considerable. The pathologic diagnosis of LCNEC is mainly based on the microscopic appearance of the tumor cells, the mitotic rate, the amount of intra-tumoral necrosis, and the presence of positive neuroendocrine markers identified by immunohistochemistry. Recently, a subdivision into two main categories was proposed based on mutation signatures involving the RB1, TP53, KRAS, and STK11/LKB1 genes, into SCLC-like (small cell lung cancer-like) and NSCLC-like (non-small cell lung cancer-like) LCNEC. In terms of treatment, surgery is still the best option for resectable, stage I–IIIA cases. Chemotherapy and radiotherapy have conflicting evidence. Etoposide/platinum remains the standard chemotherapy regimen. However, based on the newly proposed LCNEC subtypes, some retrospective series report better outcomes using a pathology-driven chemotherapy approach. Encouraging outcomes have also been reported for immunotherapy and targeted therapy, but the real impact of these strategies is still being determined in the absence of adequate prospective clinical trials. The current paper scrutinized the epidemiology, reviewed the reliability of pathologic diagnosis, discussed the need for molecular subtyping, and reviewed the heterogeneity of treatment algorithms in LCNEC.

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Section: Role Of Targeted Therapymentioning

confidence: 99%

The Unmet Diagnostic and Treatment Needs in Large Cell Neuroendocrine Carcinoma of the Lung

Buium,

Negru,

Ionescu

et al. 2023

Current Oncology

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“…Research is ongoing as to determine the efficacy in HGNEC including LCNEC. Case reports describe promising response to PRRT in patients with pulmonary LCNEC with positive somatostatin receptor scintigraphy (148). Immunohistochemical analysis of SSTR-2 expression in pulmonary neuroendocrine tumors was reviewed retrospectively in a series of 218 "clinically aggressive cases" including 60 LCNEC.…”

Section: Future Directionsmentioning

confidence: 99%

Management of Large Cell Neuroendocrine Carcinoma

et al. 2021

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BackgroundLarge cell neuroendocrine carcinoma (LCNEC) is a rare, aggressive cancer with a dismal prognosis. The majority of cases occur in the lung and the gastrointestinal tract; however, it can occur throughout the body. Recently advances in the understanding of the molecular underpinnings of this disease have paved the way for additional novel promising therapies. This review will discuss the current best evidence for management of LCNEC and new directions in the classification and treatment of this rare disease.MethodsWe performed a PubMed search for “Large cell neuroendocrine carcinoma” and “High grade neuroendocrine carcinoma.” All titles were screened for relevance to the management of LCNEC. Papers were included based on relevance to the management of LCNEC.ResultsPapers were included reviewing both pulmonary and extra pulmonary LCNEC. We summarized the data driven best practices for the management of both early and advanced stage LCNEC. We describe emerging therapies with promising potential.DiscussionLCNEC are rare and aggressive neoplasms. In advanced disease, the historical regimen of platinum based therapy in combination with etoposide or irinotecan remains among the commonly used first line therapies, however for extra thoracic LCNEC regimens like FOLFOX, FOLFOIRI and CAPTEM can also be used. Further effective and safe treatment options are desperately needed. Recently, new advances including a new understanding of the genetic subcategories of LCNEC and immunotherapy agents may guide further treatments.

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“…A lanthanide texaphyrin complex (motexafin gadolinium) has been evaluated in Phase III clinical trials for the treatment of brain metastases in non-small cell lung cancer (Mehta et al, 2009). It is also worth noting, that lanthanide radionuclides; 166 Ho (usually in a chitosan biodegradable complex form), 169 Yb, 170 Tm,and 177 Lu are often applied in oncological brachytherapy in various organs (Escala Cornejo et al 2018;Ha et al, 2013;Krishnamurthy, Weinberg, Cunha, Hsu, & Pouliot, 2011).…”

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confidence: 99%

Molecular neurochemistry of the lanthanides

Pałasz

Segovia

Skowronek

et al. 2019

Synapse

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Lanthanides, once termed rare‐earth elements, are not as sparce in the environment as their traditional name suggests. Mean litospheric concentrations are in fact comparable to the physiologically fundamental elements such as iodine, cobalt, and selenium. Recent advances in medical technology have resulted in accumulation of lanthanides presenting potential exposure to both our central and peripheral nervous systems. Extensive and detailed studies on these peculiar active metals in the context of their influence on neural functions are therefore urgently required. Almost all neurochemical effects of trivalent lanthanide ions appear to result from the similarity of their radii to the key signaling ion calcium. Lanthanides, especially La3+ and Gd3+ block different types of calcium, potassium, and sodium channels in human and animal neurons, regulate neurotransmitter turnover and release, as well as synaptic activity. Lanthanides also act as modulators of several ionotropic receptors, e.g., GABA, NMDA, and kainate and can also affect numerous signaling mechanisms including NF‐κB and apoptotic‐related endoplasmic reticulum IRE1‐XBP1, PERK, and ATF6 pathways. Several lanthanide ions may cause oxidative neuronal injuries and functional impairment by promoting reactive oxygen species production. However, cerium and yttrium oxides have some unique and promising neuroprotective properties, being able to decrease free radical cell injury and even alleviate motor impairment and cognitive function in animal models of multiple sclerosis and mild traumatic brain damage, respectively. In conclusion, lanthanides affect various neurophysiological processes, altering a large spectrum of brain functions. Thus, a deeper understanding of their potential mechanistic roles during disease and as therapeutic agents requires urgent elucidation.

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Large cell neuroendocrine carcinoma of the lung with atypical evolution and a remarkable response to lutetium Lu 177 dotatate

Cited by 9 publications

References 11 publications

The Unmet Diagnostic and Treatment Needs in Large Cell Neuroendocrine Carcinoma of the Lung

The Unmet Diagnostic and Treatment Needs in Large Cell Neuroendocrine Carcinoma of the Lung

Management of Large Cell Neuroendocrine Carcinoma

Molecular neurochemistry of the lanthanides

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