BTOG LCNEC SIG Newsletter July 2024
In 2022, a Specialist Interest Group was established by BTOG to share knowledge and experience of pulmonary Large Cell Neuro-Endocrine Cancer (LCNEC) from across the UK. The aim of this group is to establish a standard of care for diagnostic pathology assessment and treatment of LCNEC. The complexity of making an LCNEC diagnosis has led to a lack of consensus on diagnosis and management, leaving it as an unmet need that affects ~3% of UK lung cancer patients.1-2
The group, chaired by Dr. Colin Lindsay at The Christie NHS Foundation Trust and The University of Manchester, also aims to improve our biological understanding of this disease, ultimately seeking to facilitate practice-changing clinical trials for LCNEC.
Collaborative Projects & Initiatives
There are several projects ongoing or planned within the group.
LCNEC Pathology Panel
Led by Dr David Moore at UCL, a panel of pathology experts has been set up with the intention to provide diagnostic consensus on potential LCNEC cases across the UK.
A cohort of retrospective cases are currently being reviewed, with the aim of developing thresholds for levels of diagnostic certainty and quality of tissue sample.
In time we hope to utilise this panel for review of all potential UK LCNEC cases, aiming to provide support to pathologists across the country.
Further information on the development of this will be shared in the next newsletter.
If you have a possible LCNEC case of interest, please contact:
Patient Registry
To improve our understanding of the incidence of LCNEC and its management, plans are underway to introduce a patient registry of all cases of LCNEC. This will include retrospective and prospective cases.
Data collected will include pathology, immunohistochemistry, surgical resection status, systemic treatments and survival details.
Information for Patients
Agnes MacKay, Lead Lung Cancer CNS at West of Scotland Heart and Lung Centre, in collaboration with Roy Castle Lung Cancer Foundation, has been working on the first patient information leaflet written specifically for LCNEC patients and their families.
It is hoped that this will be introduced soon and available for distribution to all professionals across the UK.
Publications & Resources
Notable Recent Publications
A review of LCNEC from Italian colleagues (results of the review are correct at time of publication).
JCM | Free Full-Text | Large Cell Neuroendocrine Carcinoma of the Lung: Current Understanding and Challenges (mdpi.com)
A single-centre study in China looking at immune-checkpoint inhibition.
Efficacy and safety of immune checkpoint inhibitors in lung large-cell neuroendocrine carcinoma – Shi – Journal of Thoracic Disease (amegroups.org)
A retrospective, single-centre review of clinical characteristics and outcomes of LCNEC with brain metastases.
Clinical characteristics, treatment, and outcome of patients with large cell neuroendocrine carcinoma of the lung and brain metastases – data from a tertiary care center | Clinical & Experimental Metastasis (springer.com)
A retrospective, single-centre review of experience with chemotherapy plus immunotherapy versus chemotherapy alone.
Enhanced Efficacy of Chemotherapy by Addition of Immune Checkpoint Inhibitors in Stage IV Large Cell Neuroendocrine Carcinoma of the Lung: A Real-World Analysis [Abstract] (jcancer.org)
Single-centre molecular profiling of neuroendocrine tumours including LCNEC.
Exploring the molecular features and genetic prognostic factors of pulmonary high-grade neuroendocrine carcinomas – ScienceDirect
Resources for LCNEC
Lung – Neuroendocrine Cancer UK
BTOG does not endorse or recommend the content of external sites.
References
- Travis, W. D., Brambilla, E., Nicholson, A. G., Yatabe, Y., Austin, J. H. M., Beasley, M. B. et al. The 2015 World Health Organization classification of lung tumors. Impact of genetic, clinical and radiologic advances since the 2004 classification. J. Thorac. Oncol. 10, 1243–1260 (2015).
- Travis, W. D. Advances in neuroendocrine lung tumors. Ann. Oncol. 21, vii65–vii71 (2010).