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High-grade neuroendocrine carcinoma.
Giulio Rossi1, Alessandra Bisagni, Alberto Cavazza
1aUnit of Pathology, Azienda Ospedaliero-Universitaria Policlinico, Modena bDepartment of Oncology and Advanced Technologies, Unit of Pathology, Azienda Arcispedale S. Maria Nuova/I.R.C.C.S., Reggio Emilia, Italy.
This review updates the classification and diagnosis of high-grade lung neuroendocrine tumors, small cell carcinoma (SCC) and large cell neuroendocrine carcinoma (LCNEC). Despite identified molecular targets, effective targeted therapies are still lacking.
Area of Science:
- Pulmonology
- Oncology
- Pathology
Background:
- Lung neuroendocrine tumors encompass small cell carcinoma (SCC) and large cell neuroendocrine carcinoma (LCNEC).
- These high-grade tumors present significant diagnostic and therapeutic challenges.
- Their classification and molecular landscape are areas of active research and debate.
Purpose of the Study:
- To provide an updated review on the classification of lung SCC and LCNEC.
- To discuss current diagnostic approaches for these challenging tumors.
- To highlight potentially 'drugable' molecular alterations and their therapeutic implications.
Main Methods:
- Literature review of recent studies on lung neuroendocrine tumors.
- Analysis of controversies in SCC and LCNEC classification.
- Evaluation of diagnostic criteria and molecular targets.
Main Results:
- Key controversies include the separation of SCC and LCNEC versus a unified high-grade category and the role of Ki67.
- Diagnosis requires integrated clinical, radiological, histological, cytological, and immunohistochemical evaluation.
- Prognosis remains poor, and despite preclinical findings, no specific molecular-driven therapies are currently available.
Conclusions:
- The classification and management of high-grade neuroendocrine lung carcinomas remain complex.
- Further research into molecular targets is crucial for developing effective treatments.
- Urgent studies are needed to identify and validate new therapeutic strategies.
