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World J Clin Oncol. Aug 24, 2021; 12(8): 664-674
Published online Aug 24, 2021. doi: 10.5306/wjco.v12.i8.664
Adjuvant therapy for lung neuroendocrine neoplasms
Robert A Ramirez, Katharine Thomas, Aasems Jacob, Karen Lin, Yvette Bren-Mattison, Aman Chauhan
Robert A Ramirez, Department of Medicine-Division of Hematology/Oncology, Vanderbilt University Medical Center, Nashville, TN 37232, United States
Katharine Thomas, Department of Hematology and Oncology, Louisiana State University Health Sciences Center, New Orleans, LA 70112, United States
Aasems Jacob, Aman Chauhan, Division of Medical Oncology, University of Kentucky, Lexington, KY 40536, United States
Karen Lin, Department of Oncology, Brookwood Baptist Health, Birmingham, AL 35209, United States
Yvette Bren-Mattison, Department of Surgery, Louisiana State University Health Sciences Center, New Orleans, LA 70112, United States
Yvette Bren-Mattison, New Orleans Louisiana Neuroendocrine Tumor Specialists (NOLANETS), Ochsner Medical Center, Kenner, LA 70065, United States
Author contributions: Ramirez RA and Chauhan A contributed to the conception and design; all authors contributed to the collection and assembly of data, manuscript writing, final approval of manuscript, and accountable for all aspects of work.
Conflict-of-interest statement: Robert A Ramirez, DO serves as a speaker for Merck & Co., Inc., Advanced Accelerator Applications, Genentech, Inc., AstraZeneca, and Ipsen Biopharmaceuticals, Inc. He is also a consultant for Curium Pharma, Advanced Accelerator Applications, AstraZeneca, Ipsen Biopharmaceuticals and Novartis Pharmaceuticals, Corp. He receives research funding from Aadi Biosciences and Merck & Co., Inc. Aman Chauhan, MD serves as an advisor for Novartis/AAA, Ipsen, Lexicon, and TerSera. He has received grants from BMS, Clovis, TerSera, Nanopharmaceuticals, EMD Serono, and ECS Progastrin. No other authors have conflicts of interest to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Robert A Ramirez, DO, FACP, Associate Professor, Department of Medicine-Division of Hematology/Oncology, Vanderbilt University Medical Center, 2220 Pierce Ave, 7770 Preston Research Building, Nashville, TN 37232, United States. robert.ramirez@vumc.org
Received: February 26, 2021
Peer-review started: February 26, 2021
First decision: May 7, 2021
Revised: May 19, 2021
Accepted: August 9, 2021
Article in press: August 9, 2021
Published online: August 24, 2021
Processing time: 177 Days and 9.3 Hours
Abstract

Pulmonary neuroendocrine neoplasms (NENs) represent a minority of lung cancers and vary from slower growing pulmonary carcinoid (PC) tumors to aggressive small cell lung cancer (SCLC). While SCLC can account for up to 15% of lung cancer, PCs are uncommon and represent about 2% of lung cancers. Surgical resection is the standard of care for early-stage PCs and should also be considered in early stage large cell neuroendocrine carcinoma (LCNEC) and SCLC. Adjuvant treatment is generally accepted for aggressive LCNEC and SCLC, however, less well established for PCs. Guidelines admit a lack of trials to support a high-level recommendation for adjuvant therapy. This manuscript will discuss the role for adjuvant therapy in NENs and review the available literature.

Keywords: Neuroendocrine; Adjuvant therapy; Lung; Pulmonary carcinoid; Small cell lung cancer

Core Tip: Neuroendocrine neoplasms of the lung are uncommon malignancies. They vary in degrees of aggressiveness from the slow growing typical carcinoid tumors to the very fast-growing small cell lung cancer. While surgical resection should be considered for early-stage disease, the role of adjuvant therapy is less well established. Guidelines from different organizations vary, citing a lack of trials to support a high-level recommendation. This manuscript will discuss the evidence for and against adjuvant therapy in neuroendocrine neoplasms of the lung.