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Review
. 2021 Nov 26;13(23):5948.
doi: 10.3390/cancers13235948.

Effect of Adjuvant and Palliative Chemotherapy in Large Cell Neuroendocrine Carcinoma of the Lung: A Systematic Review and Meta-Analysis

Hao Chen  1 , Masashi Ishihara  1 , Nobuyuki Horita  2 , Hiroki Kazahari  1 , Ryusuke Ochiai  1 , Shigeru Tanzawa  1 , Takeshi Honda  1 , Yasuko Ichikawa  1 , Kiyotaka Watanabe  1 , Nobuhiko Seki  1
Affiliations
Review

Effect of Adjuvant and Palliative Chemotherapy in Large Cell Neuroendocrine Carcinoma of the Lung: A Systematic Review and Meta-Analysis

Hao Chen et al. Cancers (Basel). .

Abstract

Background: Pulmonary large cell neuroendocrine carcinoma (LCNEC) is a rare subset of lung carcinoma with poor overall survival.

Methods: A systematic review following a meta-analysis of studies was performed to identify the effect of different selections of chemotherapy in LCNEC. Articles providing overall survival data for adjuvant chemotherapy or palliative chemotherapy for LCNEC were eligible. The odds ratio (OR) of mortality at one or two years after chemotherapy was evaluated.

Results: A total of 16 reports were finally included in the quantitative synthesis, involving a total of 5916 LCNEC patients. Adjuvant chemotherapy was administered to 1303 patients, and palliative chemotherapy was administered to 313 patients using either a small cell lung cancer (SCLC) or a non-small cell lung cancer (NSCLC) regimen. The OR for adjuvant chemotherapy was 0.73 (95% confidence interval (CI): 0.59 to 0.89, p = 0.002). The SCLC regimen showed an OR of 0.52 (95% CI: 0.11 to 2.38, p = 0.40) after one year, and 0.32 (95% CI: 0.11 to 0.89, p = 0.03) after two years, compared with the NSCLC regimen.

Conclusions: Adjuvant chemotherapy for pulmonary large cell neuroendocrine carcinoma improved the outcome after surgery. The SCLC regimen showed better survival than the NSCLC regimen as palliative chemotherapy.

Keywords: chemotherapy; large cell neuroendocrine carcinoma of the lung; non-small cell lung cancer; regimen; small cell lung cancer.

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Conflict of interest statement

Nobuhiko Seki has received research grants and a speaker honorarium from Ono Pharmaceutical Company, Bristol-Myers Company, MSD, AstraZeneca, Chugai Pharmaceutical, Boehringer Ingelheim, Pfizer Japan, Eli Lilly Japan, Taiho Pharmaceutical, Daiichi Sankyo Company, and Merck Biopharma Company.

Figures

Figure 1
Figure 1
Effect of adjuvant chemotherapy after five years in patients of all stages.
Figure 2
Figure 2
Subgroup analysis of adjuvant chemotherapy in early stage. (a) The odds ratio of adjuvant chemotherapy in patients with stage IA; (b) odds ratio of adjuvant chemotherapy in patients with stage IB; (c) odds ratio of adjuvant chemotherapy in patients with stage I.
Figure 3
Figure 3
Different effects of chemotherapy by the SCLC or the NSCLC regimen. (a) The odds ratio of the small cell regimen versus the non-small cell regimen after one year; (b) odds ratio of the small cell regimen versus the non-small cell regimen after two years.
See this image and copyright information in PMC

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