The treatment of undifferentiated neuroendocrine tumors

The aggressiveness of poorly-differentiated neuroendocrine tumors is simila r to small-cell lung cancer within a median survival of 6 months without tr eatment. Most patients have metastatic disease and poor condition at the ti me of diagnosis, and cannot be approached surgically with curative intent. Moertel et al. [Treatment of neuroendocrine carcinomas with combined etopos ide and cisplatin, Cancer 1991:68:227-232] reported an objective response r ate of 67% with a chemotherapy regimen combining etoposide plus cisplatin, with a median survival of 19 months and a median time to progression of 11 months. Since this publication, this regimen has been considered as the ref erence treatment for poorly-differentiated neuroendocrine tumors. A French retrospective study has recently confirmed the high chemosensitivity of tho se tumors. However, the prognosis remains poor with a 2-year survival lower than 20% and other therapeutic approaches should be developed. (C) 2001 El sevier Science Ireland Ltd. All rights reserved.