title: Evaluation of the efficacy of cisplatin-etoposide and the role of thoracic radiotherapy and prophylactic cranial irradiation in LCNEC.
abstract: In small-cell lung cancer (SCLC), the role of chemotherapy and radiotherapy is well established. Large-cell neuroendocrine carcinoma (LCNEC) shares several clinicopathological features with SCLC, but its optimal therapy is not defined. We evaluated clinical response and survival outcomes of advanced LCNEC treated in first-line therapy compared with SCLC. 72 patients with stage III-IV LCNEC (n=28) and extensive-stage SCLC (ES-SCLC) (n=44) received cisplatin-etoposide with/without thoracic radiotherapy (TRT) and prophylactic cranial irradiation (PCI). Comparing LCNEC with SCLC, we observed similar response rates (64.2%versus59.1%), disease control rates (82.1%versus88.6%), progression-free survival (mPFS) (7.4versus6.1 months) and overall survival (mOS) (10.4versus10.9 months). TRT and PCI in both histologies showed a benefit in mOS (34versus7.8 months and 34versus8.6 months, both p=0.0001). LCNEC patients receiving TRT showed an improvement in mPFS and mOS (12.5versus5 months, p=0.02 and 28.3versus5 months, p=0.004), similarly to ES-SCLC. PCI in LCNEC showed an increase in mPFS (20.5versus6.4 months, p=0.09) and mOS (33.4versus8.6 months, p=0.05), as in ES-SCLC. Advanced LCNEC treated with SCLC first-line therapy has a similar clinical response and survival outcomes to ES-SCLC.
authors.affiliation: Dept of Medical Oncology Unit A, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Arsela
authors.initials: A
authors.lastname: Prelaj
authors.affiliation: Department of Medical Oncology, IRCCS San Martino IST, Genoa, Italy.
authors.forename: Sara Elena
authors.initials: SE
authors.lastname: Rebuzzi
authors.affiliation: Dept of Medical Oncology Unit A, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Del Bene
authors.affiliation: Dept of Medical Oncology Unit A, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Julio Rodrigo
authors.initials: JR
authors.lastname: Giròn Berrìos
authors.affiliation: Dept of Medical Oncology Unit A, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Emiliani
authors.affiliation: Dept of Medical Oncology Unit A, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Lucilla
authors.initials: L
authors.lastname: De Filippis
authors.affiliation: Dept of Medical Oncology Unit A, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Alessandra Anna
authors.initials: AA
authors.lastname: Prete
authors.affiliation: Dept of Medical Oncology Unit A, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Pecorari
authors.affiliation: Dept of Medical Oncology Unit A, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Gaia
authors.initials: G
authors.lastname: Manna
authors.affiliation: Department of Public Health and Infectious Diseases, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Ferrara
authors.affiliation: Polo Oncologico, Azienda Ospedaliero-Universitaria Pisana, Istituto Toscano Tumori, Pisa, Italy University of Pisa, Pisa, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Rossini
authors.affiliation: Dept of Medical Oncology Unit A, Policlinico Umberto I, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Flavia
authors.initials: F
authors.lastname: Longo