Effect of platinum combined with irinotecan or paclitaxel against large cell neuroendocrine carcinoma of the lung

Background: The efficacy of chemotherapy in patients with large cell neuroendocrine carcinoma of the lung (LCNEC) remains unclear. Methods: Of 42 consecutive patients with LCNEC, 22 with measurable disease receiving chemotherapy were enrolled as the subjects of this study. The clinical characteristics and objective responses to chemotherapy in these patients were analysed retrospectively. Results: The distribution of the disease stage in the patients consisting of 21 males and one female (median age: 67 years; range: 47-78 years) was as follows: stage 1113 (n = 1), stage IIIA (n = 1), stage 11113 (n = 5), stage IV (n = 8), and post-operative recurrence (n = 7). Chemotherapy consisted of cisplatin and irinotecan (n = 9), a platinum agent and paclitaxel (n = 6), paclitaxel alone (n = 1), cisplatin and vinorelbine (n = 1), cisplatin and docetaxel (n = 1), and a platinum and etoposide (n = 4). The objective response rate in the 22 patients was 59.1% (95% Cl, 38.1-80.1). An objective response was obtained in five of the nine patients receiving irinotecan and five of the seven patients receiving paclitaxel. The progression-free survival, median overall survival and 1-year survival rates were 4.1 months (95% Cl, 3.1-5.1), 10.3 months (95% Cl, 5.8-14.8) and 43.0% (95% Cl, 20.7-65.3), respectively. The median overall survival of the patients treated with irinotecan or paclitaxel was 10.3 months (95% Cl, 0-21.8), and the 1-year survival rate of these patients was 47.6% (95% Cl, 20.4-74.8). Conclusion: Our results suggest that irinotecan and paclitaxel may be active against LCNEC.