J.Jpn. Surg. Soc.. 122(1): 32-37, 2021

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Feature topic

THERAPEUTIC STRATEGY FOR LARGE-CELL NEUROENDOCRINE CARCINOMA OF THE LUNG

Large-cell neuroendocrine carcinoma of the lung is categorized as a neuroendocrine tumor and shows a worse prognosis than non-small-cell lung cancer. Radical lobectomy and lymphadenectomy are recommended for resectable cases. After radical resection, adjuvant chemotherapy with regimens for small-cell lung cancer is recommended for all resected cases including those in stage IA. Stereotactic body radiotherapy yields a worse prognosis than surgery. For patients who do not undergo surgery, radiotherapy is effective in improving the prognosis. For advanced and relapsed cases, chemotherapy with non-small-cell cancer or small-cell cancer regimens is recommended. Although the genomic EGFR mutation or ALK fusion protein is not frequently found, EGFR tyrosine kinase inhibitors and ALK inhibitors are effective in patients with positive biomarkers. Immune checkpoint inhibitors may be effective, but there are only a few reports on their use so far.

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