2024 World Conference on Lung Cancer (WCLC) - Posters-P3.13C.09 First-Line Treatments for Advanced Pure Large Cell Neuroendocrine Tumors (LCNEC):Insights from a Global Clinico-Genomic Study

P3.13C.09 First-Line Treatments for Advanced Pure Large Cell Neuroendocrine Tumors (LCNEC):Insights from a Global Clinico-Genomic Study

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This document highlights a comprehensive study on survival outcomes and potential therapeutic targets for pulmonary large cell neuroendocrine carcinoma (LCNEC). The study utilizes data from two cohorts totaling 590 patients with advanced LCNEC to compare the efficacy of first-line (1L) systemic therapies, including chemotherapy (chemo), immunotherapy (IO), and chemoimmunotherapy (chemo(IO)), and integrates multiomics approaches like whole exome sequencing (WES) and transcriptome analyses to discover new therapeutic targets.<br /><br />The key findings indicate that first-line treatment regimens—chemo(IO), chemotherapy alone, and IO-based treatments—yield similar survival outcomes for patients, with no unexpected toxicities observed across these options. The study identifies FGL-1 and SPINK1 as potential therapeutic targets for NSCLC-like LCNECs and highlights DLL3 as a target for SCLC-like LCNECs. Furthermore, it documents the gene expression profiles and mutation prevalence in these LCNEC subtypes, showing distinct genetic landscapes between them.<br /><br />Survival outcome analysis across various 1L treatment strategies found median survival times of 17.6, 14.9, and 21.7 months for chemo(IO), chemotherapy alone, and immunotherapy, respectively. These insights support the development of more targeted treatment strategies, potentially leveraging FGL-1 and SPINK1 targeted therapies or DLL3-directed treatments for tailored interventions based on tumor subtype.<br /><br />Overall, this study emphasizes the importance of personalized approaches in treating LCNEC subtypes and suggests that multiomics data combined with clinical outcomes can identify novel therapeutic opportunities. The findings can guide future research and drug development aimed at improving survival rates for this challenging cancer type, which currently has a dismal 5-year overall survival rate of 15-20%.

Asset Subtitle

Amin Nassar

Meta Tag

Speaker Amin Nassar

Topic SCLC & Neuroendocrine Tumors

Keywords

pulmonary large cell neuroendocrine carcinoma

LCNEC

first-line systemic therapies

chemoimmunotherapy

multiomics approaches

FGL-1

SPINK1

DLL3

survival outcomes

personalized treatment