How would you approach a poorly differentiated neuroendocrine carcinoma of the stomach with small cell morphology without any evidence of peritoneal or distant spread?

Would you treat with typical small cell paradigms such as surgery followed by adjuvant platinum doublet +/- radiation vs definitive chemoradiation? Or typical gastric carcinoma perioperative chemo? How/would you integrate IO (extrapolating from IMPOWER 133)?

Answer from: Medical Oncologist at Community Practice

High grade neuroendocrine carcinoma (HG-NEC) is extremely sensitive to chemo-radiotherapy. Unfortunately, they often relapse/reoccur despite treatment with curative intent for early stage disease. In my practice, I would avoid surgery for the given clinical scenario and proceed with chemo-radi...

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How would you approach a poorly differentiated neuroendocrine carcinoma of the stomach with small cell morphology without any evidence of peritoneal or distant spread?

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