title: Systemic therapy, clinical outcomes, and overall survival in locally advanced or metastatic pulmonary carcinoid: a brief report.
abstract: BACKGROUND
  Data to guide the management of advanced pulmonary carcinoid (APC) come from retrospective reports and subgroup analyses of trials that included mainly extrapulmonary carcinoid tumors. We report the largest series to date of 49 patients with locally advanced or metastatic pulmonary carcinoid.
  
  
  METHODS
  The Johns Hopkins Pathology Database was reviewed for APC patients treated between January 1992 and December 2012. Data on time to recurrence, progression-free survival, and overall survival were estimated by using the Kaplan-Meier method.
  
  
  RESULTS
  Forty-nine patients were treated for APC in the specified time period. Median time to recurrence after surgical resection was 2.5 years (atypical carcinoid [AC] versus typical carcinoid [TC], 2.5 versus 6.3 years; p = 0.063). Median survival with advanced disease was 7.1 years and significantly longer for TC compared with AC (10.2 versus 4 years; p = 0.009). Among the diverse systemic therapies used, responses occurred in four of 17 patients (23.5%) who received platinum/etoposide with a median progression-free survival of 7 months.
  
  
  CONCLUSIONS
  Although systemic chemotherapy has moderate activity for APC, novel approaches are required. TC and AC, although both classified as pulmonary carcinoid, are clearly different clinical and molecular entities and require separate treatment paradigms in the advanced/metastatic setting.
authors: Departments of *Medical Oncology, †Surgery, and ‡Pathology, Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, Maryland; and §Medical Oncology Branch, National Cancer Institute, Bethesda, Maryland.
authors: Patrick M
authors: PM
authors: Forde
authors: Craig M
authors: CM
authors: Hooker
authors: Sosipatros A
authors: SA
authors: Boikos
authors: Iacope
authors: I
authors: Petrini
authors: Giuseppe
authors: G
authors: Giaccone
authors: Charles M
authors: CM
authors: Rudin
authors: Stephen C
authors: SC
authors: Yang
authors: Peter B
authors: PB
authors: Illei
authors: Christine L
authors: CL
authors: Hann
authors: David S
authors: DS
authors: Ettinger
authors: Julie R
authors: JR
authors: Brahmer
authors: Ronan J
authors: RJ
authors: Kelly
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002276:Carcinoid Tumor / Q000188:drug therapy / Q000401:mortality* / Q000556:secondary; D003131:Combined Modality Therapy; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology; D009367:Neoplasm Staging; D010984:Platinum / Q000008:administration & dosage; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D010984:Platinum; D005047:Etoposide