Overview
Neuroendocrine neoplasms of the lung (NEN-L) are rare and aggressive cancers, with large-cell neuroendocrine carcinoma (LCNEC) being a particularly challenging subtype. Because of their rarity and diversity, there is no clear standard of care for patients with metastatic LCNEC. This study used real-world data from the US-based Flatiron Health electronic health record-derived database to better understand how patients with NEN-L are treated and their clinical outcomes in the real-world.
The study included 154 patients diagnosed with metastatic NEN-L (excluding small cell lung cancer) between October 2018 and April 2023 who received systemic anticancer therapy. The analysis found that most patients received platinum-based chemotherapy, either alone or combined with immune checkpoint inhibitors, as their first treatment. For later lines of therapy, a wide variety of nonplatinum chemotherapy drugs were used, reflecting the lack of consensus on optimal care. Clinical outcomes remained suboptimal, with median time to next treatment ranging from 4 to 5 months across treatment lines. Only about half of patients moved on to second-line therapy, and less than a quarter received a third line.
Why this matters
This research provides important real-world evidence to highlight an urgent unmet need for patients with metastatic NEN-L. These findings emphasize the need for more effective and standardized treatment options for patients with metastatic NEN-L, as current real-world strategies are highly variable and often yield limited benefit.