Clinical responses of large cell neuroendocrine carcinoma of the lung to cisplatin-based chemotherapy

Background: The efficacy of chemotherapy in patients with large cell neuroendocrine carcinoma of the lung (LCNEC) remains unclear. Methods: Patients with LCNEC who received cisplatin-based chemotherapy were identified by reviewing 567 autopsied and 2790 surgically resected lung cancer patients. The clinical characteristics and objective responses to chemotherapy in these patients were analyzed. Results: Overall, 20 cases of LCNEC were identified, including stage IIIA (n = 3), stage IIIB (n = 6), stage IV (n = 6) and postoperative recurrence (n = 5) cases. Six patients had received prior chemotherapy, and 14 were chemo-naive patients. The patients had received a combination of cisplatin and etoposide (n = 9), cisplatin, vindesine and mitomycin (n = 6), cisplatin and vindesine (n = 4), or cisplatin alone (n = 1). One patient showed complete response and nine showed partial response, yielding an objective response rate of 50%. The response rate did not differ between patients with the initial diagnosis of SCLC and those with the initial diagnosis of NSCLC, however, the response rate in chemo-naive patients (64%) was significantly different from that in previously treated patients (17%). Conclusions: Our results suggest that the response rate of LCNEC to cisplatin-based chemotherapy was comparable to that of SCLC.