What second line therapy do you use for metastatic gastroenterohepatic neuroendocrine carcinoma (G3 NEC) with progression after platinum based therapy?
There is some data on TMZ and 5FU based regimens, but convincing evidence is lacking. How would you approach this situation?
Answer from: Medical Oncologist at Academic Institution
I completely agree that convincing evidence is lacking. We tend to lean on 5-FU and irinotecan based regimens, based on the FFCD-GTE data and the case report-level data with FOLFIRINOX (PMID 25662891). While there are also retrospective data with TMZ-based regimens, published data are no...
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Answer from: Medical Oncologist at Community Practice
In the absence of a clinical trial, I agree that FOLFIRI would be the best choice and is generally well tolerated as second line therapy. I would certainly offer tumor genotyping as NECs are generally high mutational burden malignancies which may identify drugable targets and eligibility for clinica...