Large Cell Neuroendocrine in Liver??? - 1273718

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Large Cell Neuroendocrine in Liver??? - 1273718

Dr. West et al,
I was sailing along just fine on Alimta until a brain met appeared in an MRI on 2/22/16. Gamma Knife seems to have destroyed it.

Then, a 3/8/2016 CT found 6 liver lesions not seen on a CT 3 months earlier. A biopsy of the largest was done and the pathologist's diagnosis was somewhat inconclusive--- "metastatic carcinoma with neuroendocrine features, favors new primary."
I suspect my oncologist will treat this as Large Cell Neuroendocrine, i. e., with carbo and etoposide.
What PFS and OS rates are seen for this cancer with this combination?

Dr. West's 4/19/16 write-up of Large Cell Neuroendocrine mentions "other options are certainly reasonable..." What are those other options? I am looking for something gentler than carbo and etoposide.


Aug,2010 LU lobectomy-T 8.2cm,N0,M0;DX “adeno, mod diff, mostly NM-BAC.
No growth noted in 3-month scans until Sept 2011
Oct 2011 began carb/alimta,avastin; stable during 4 cycles;began break
No growth noted in 3-month scans until Oct 2012
Oct 2012 began Alimta and Avastin; stable during 4 cycles; began break
No growth noted in 3-month scans until June 2014
Sept 2014 began MPDL3280A “Birch” trial
Told “it’s not working” after 6 infusions
Jan 2015 began Alimta
Feb 2016 MRI finds one brain met subsequently destroyed by Gamma Knife
April 2016 CT finds mostly stable lung lesions and six new liver lesions; Alimta stopped
April 2016 Biopsy of liver finds "neuroendocrine features

Hi Nancy,

Hi Nancy,
I so hate to hear about this new info. If it's believed to be a primary in the liver it's possible curative treatment is offered. I'll make sure a faculty comments.

Best of luck and cyber hugs

Since the pathology report

Since the pathology report was somewhat inconclusive, I'd want a second opinion on it. Neuroendocrine are not shown to have a liver primary. See the attached link. If this is carcinoid neuroendocrine tumors, then a specialist should be seen to treat it. I could be wrong for sure, but this is what I'm reading at a John Hopkins link. I researched this before and found this article so I saved it. My best to your wife.
Take care, Judy