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. 2017 Mar 29;3(1):00128-2016.
doi: 10.1183/23120541.00128-2016. eCollection 2017 Jan.

Evaluation of the efficacy of cisplatin-etoposide and the role of thoracic radiotherapy and prophylactic cranial irradiation in LCNEC

Arsela Prelaj  1 , Sara Elena Rebuzzi  2 , Gabriella Del Bene  1 , Julio Rodrigo Giròn Berrìos  1 , Alessandra Emiliani  1 , Lucilla De Filippis  1 , Alessandra Anna Prete  1 , Silvia Pecorari  1 , Gaia Manna  1 , Carla Ferrara  3 , Daniele Rossini  4 , Flavia Longo  1
Affiliations

Evaluation of the efficacy of cisplatin-etoposide and the role of thoracic radiotherapy and prophylactic cranial irradiation in LCNEC

Arsela Prelaj et al. ERJ Open Res. .

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% versus 59.1%), disease control rates (82.1% versus 88.6%), progression-free survival (mPFS) (7.4 versus 6.1 months) and overall survival (mOS) (10.4 versus 10.9 months). TRT and PCI in both histologies showed a benefit in mOS (34 versus 7.8 months and 34 versus 8.6 months, both p=0.0001). LCNEC patients receiving TRT showed an improvement in mPFS and mOS (12.5 versus 5 months, p=0.02 and 28.3 versus 5 months, p=0.004), similarly to ES-SCLC. PCI in LCNEC showed an increase in mPFS (20.5 versus 6.4 months, p=0.09) and mOS (33.4 versus 8.6 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.

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Conflict of interest statement

Conflict of interest: None declared.

Figures

FIGURE 1
FIGURE 1
a–d) Comparison of Kaplan–Meier curves of a) progression-free survival (PFS) and c) overall survival (OS) in large-cell neuroendocrine carcinoma (LCNEC) patients undergoing first-line therapy with cisplatin–etoposide and Kaplan–Meier curves of b) PFS and d) OS in small-cell lung cancer (SCLC) patients undergoing the same therapy. e, f) Kaplan–Meier curves for OS according to the use of e) thoracic radiotherapy (TRT) and f) prophylactic cranial irradiation (PCI) following first-line chemotherapy (CT) in high-grade neuroendocrine carcinoma patients.
FIGURE 2
FIGURE 2
Kaplan–Meier curves for a, b) progression-free survival (PFS) and c, d) overall survival (OS) in a, c) large-cell neuroendocrine carcinoma patients and b, d) small-cell lung cancer patients according to the use of thoracic radiotherapy (TRT). CT: chemotherapy.
FIGURE 3
FIGURE 3
Kaplan–Meier curves for a, b) progression-free survival (PFS) and c, d) overall survival (OS) in a, c) large-cell neuroendocrine carcinoma patients and b, d) small-cell lung cancer patients according to the use of prophylactic cranial irradiation (PCI).
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