Systemic treatment for lung carcinoids: from bench to bedside

Area of Science:

• Oncology
• Pulmonology
• Molecular Biology

Background:

• Lung carcinoids are well-differentiated neuroendocrine neoplasms with indolent behavior but associated with worse survival.
• They represent a distinct biological entity from poorly differentiated neuroendocrine tumors, possessing unique molecular alterations.
• Current therapeutic strategies for lung carcinoids are limited, necessitating the development of novel drugs and treatment approaches.

Purpose of the Study:

• To review current therapeutic options for lung carcinoids.
• To explore potential molecular targets for new drug development.
• To discuss future perspectives in managing well-differentiated bronchopulmonary neuroendocrine neoplasms.

Main Methods:

• Extensive literature review of scientific publications.
• Analysis of available systemic therapies including somatostatin analogs, peptide receptor radionuclide therapy, everolimus, and chemotherapy.
• Identification of molecular alterations in carcinoid tumors as potential therapeutic targets.

Main Results:

• Systemic therapy is the primary option for advanced and unresectable lung carcinoid disease.
• No single, definitive treatment strategy exists; tailored algorithms balancing efficacy and safety are recommended.
• Numerous molecular alterations in carcinoid tumors present opportunities for targeted therapy development.

Conclusions:

• Lung carcinoids require tailored treatment strategies due to limited therapeutic options and variable efficacy.
• Identifying "druggable" molecular targets in low-grade lung carcinoids is crucial for advancing treatment.
• Further research evaluating therapies in homogeneous patient populations may enhance treatment efficacy and personalization.