The outcomes of different regimens depend on the molecular subtypes of pulmonary large‐cell neuroendocrine carcinoma: A retrospective study in China

• Published in: Cancer medicine (Malden, MA) MA), 2024-01, Vol.13 (1), p.e6834-n/a
• Main Authors: Wang, Zhaojue, Wu, Yang, Lu, Tao, Xu, Yan, Chen, Minjiang, Zhong, Wei, Zhao, Jing, Wang, Mengzhao
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Biomarkers; Biopsy; Carcinoma; Carcinoma, Large Cell - drug therapy; Carcinoma, Large Cell - genetics; Carcinoma, Large Cell - mortality; Carcinoma, Large Cell - pathology; Carcinoma, Large Cell - therapy; Carcinoma, Neuroendocrine - drug therapy; Carcinoma, Neuroendocrine - genetics; Carcinoma, Neuroendocrine - mortality; Carcinoma, Neuroendocrine - pathology; Carcinoma, Neuroendocrine - therapy; Chemotherapy; China; Classification; clinical outcome; Female; Genes; Humans; Lung cancer; Lung carcinoma; Lung Neoplasms - drug therapy; Lung Neoplasms - genetics; Lung Neoplasms - mortality; Lung Neoplasms - pathology; Lung Neoplasms - therapy; Male; Medical prognosis; Medical records; Middle Aged; molecular subtypes; Morphology; Mutation; Neuroendocrine tumors; Non-small cell lung carcinoma; Oncology; Patients; pulmonary large‐cell neuroendocrine carcinoma; Retrospective Studies; Treatment Outcome; treatment regimen; Tumors
• ISSN: 2045-7634; 2045-7634
• DOI: 10.1002/cam4.6834

Background The optimal systemic treatment for pulmonary large‐cell neuroendocrine carcinoma (LCNEC) remains controversial, and recent advances in LCNEC molecular subtype classification have provided potential strategies for assisting in treatment decisions. Our study aimed to investigate the impact of treatment regimens, molecular subtypes and their concordance on clinical outcomes of patients diagnosed with LCNEC. Patients and Methods All patients diagnosed with advanced pulmonary LCNEC in Peking Union Medical College Hospital (PUMCH) between January 2000 and October 2021 were enrolled in this retrospective study. The tumor samples were collected and sequenced using a tumor‐specific gene panel, while clinical information was retrieved from the medical records system. The survival and therapeutic response were analyzed and compared between different subgroups classified by treatment regimen (SCLC or NSCLC‐based), molecular subtype (type I or II) or the combination. Results In univariate subgroup analysis categorized only by treatment regimen or molecular subtype, there were no differences identified in DCR, ORR, PFS, or OS. Nevertheless, the group with consistent treatment regimen and molecular subtype exhibited significantly longer OS than that of the inconsistent group (median OS 37.7 vs. 8.3 months; p = 0.046). Particularly, the OS of patients with type II LCNEC treated with SCLC‐based regimen was significantly prolonged than that of others (median 37.7 vs. 10.5 months; p = 0.039). Conclusions Collectively, our study revealed the clinical outcomes of different treatment regimens for LCNEC patients highly depend on their molecular subtypes, highlighting the need for sequencing‐guided therapy.