{
  "abstract": "Pulmonary large-cell neuroendocrine carcinoma (LCNEC) is a rare, aggressive malignancy with substantial biological heterogeneity. Genomic studies identify SCLC-like and NSCLC-like spectra, but genomic categories overlap incompletely with transcriptional states. Morphology remains essential: neither neuroendocrine marker positivity nor RB1 status alone distinguishes LCNEC from small-cell lung cancer (SCLC). This narrative review integrates diagnostic limitations, stage-based management, and the clinical implications of profiling. Surgery with systematic nodal assessment is central for resectable disease; postoperative platinum chemotherapy has greater support than perioperative immunotherapy. In advanced disease, platinum-etoposide is a commonly used reference regimen. Retrospective associations involving platinum-gemcitabine or platinum-taxanes in RB1-wild-type tumors remain hypothesis-generating and should not be extended to pemetrexed. LANCE, a durvalumab phase II trial, and preliminary NEJ044 findings provide prospective chemo-immunotherapy observations, although randomized LCNEC-specific evidence remains absent. No standard second-line regimen is established. Rare actionable drivers may support matched treatment, whereas DLL3-directed approaches and FGL1/SPINK1-associated strategies require clinical validation. We propose an evidence-qualified framework separating stage-based care, individualized molecular considerations, and clinical-trial strategies.",
  "abstract_shown": true,
  "affiliations": [
    "Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan",
    "Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Gangshan Hospital, Kaohsiung Medical University, Kaohsiung 820011, Taiwan",
    "Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung 80708, Taiwan",
    "Cancer Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan",
    "School of Post-Baccalaureate Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 8,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Tai-Huang Lee"
    },
    {
      "affs": [
        0,
        1
      ],
      "name": "Juei-Yang Ma"
    },
    {
      "affs": [
        0
      ],
      "name": "Huei-Yang Hung"
    },
    {
      "affs": [
        0,
        2
      ],
      "name": "Chia-Yu Kuo"
    },
    {
      "affs": [
        3
      ],
      "name": "Chin-Ling Chen"
    },
    {
      "affs": [
        3
      ],
      "name": "Pei-Chi Tsai"
    },
    {
      "affs": [
        0,
        3,
        4
      ],
      "name": "Cheng-Hao Chuang",
      "orcid": "0000-0003-4239-4012"
    },
    {
      "affs": [
        0,
        4
      ],
      "name": "Chih-Jen Yang",
      "orcid": "0000-0002-3576-7936"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/767g7heaqkjgw.bib",
  "cited_by": 0,
  "doi": "10.3390/cancers18213585",
  "fulltext_url": null,
  "id": "767g7heaqkjgw",
  "issns": [
    "2072-6694"
  ],
  "landing_url": "https://www.mdpi.com/2072-6694/18/21/3585",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [],
  "openalex": null,
  "pdf_url": null,
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-07",
  "publisher": "MDPI AG",
  "ris": "https://research.draconitic.com/paper/767g7heaqkjgw.ris",
  "sources": [
    {
      "first_seen": "2026-11-10T00:21:40Z",
      "native_id": "10.3390/cancers18213585",
      "source": "crossref",
      "url": "https://www.mdpi.com/2072-6694/18/21/3585"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:2072-6694",
      "subfield": "oncology"
    }
  ],
  "title": "Pulmonary Large-Cell Neuroendocrine Carcinoma: Molecular Heterogeneity, Current Treatment and the Emerging Precision-Oncology Paradigm",
  "title_text": "Pulmonary Large-Cell Neuroendocrine Carcinoma: Molecular Heterogeneity, Current Treatment and the Emerging Precision-Oncology Paradigm",
  "type": "peer-reviewed",
  "updated_at": "2026-11-10T00:21:40Z",
  "url": "https://research.draconitic.com/paper/767g7heaqkjgw",
  "venue": "Cancers",
  "versions": []
}