Lung neuroendocrine tumours (typical and atypical carcinoid): lines of therapy

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5 standard-of-care settings across 5 lines and 1 biomarker subgroup. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.

Line	All comers
Screening, prevention and diagnosis	1
Early / localised	1
Advanced, first line	1
Second line	1
Other settings	1

Screening, prevention and diagnosis

Subgroup	Setting	Approach	Products and trials	Guideline	Evidence
All comers	Diagnosis and staging	Bronchoscopy with biopsy for central tumours, CT of the chest and abdomen, somatostatin receptor PET, and pathology graded by mitotic count and necrosis.	Bronchoscopy (EBUS, robotic navigation)CT (computed tomography)Somatostatin receptor PET (68Ga/64Cu-DOTATATE)Gallium-68 DOTATATE (and Cu-64 DOTATATE)Neuroendocrine tumour grade (Ki-67) and WHO classification	NCCN Guidelines: Neuroendocrine and Adrenal Tumors	89

Early / localised

Subgroup	Setting	Approach	Products and trials	Guideline	Evidence
All comers	Localised disease	Lobectomy or sleeve resection with systematic nodal dissection; endobronchial resection for patients unfit for surgery; no adjuvant therapy.	LobectomyRobotic & minimally invasive surgery	NCCN Guidelines: Neuroendocrine and Adrenal Tumors	40

Advanced, first line

Subgroup	Setting	Approach	Products and trials	Guideline	Evidence
All comers	Advanced, somatostatin receptor-positive, slow tempo	Octreotide or lanreotide, by extrapolation from gut trials and the SPINET study.	Somatostatin analogues (octreotide, lanreotide)CLARINET	NCCN Guidelines: Neuroendocrine and Adrenal Tumors	81

Second line

Subgroup	Setting	Approach	Products and trials	Guideline	Evidence
All comers	Advanced, progressive	Everolimus (RADIANT-4); cabozantinib (CABINET); lutetium-177 dotatate off-label for receptor-positive tumours; temozolomide-based chemotherapy for atypical carcinoids needing shrinkage.	EverolimusRADIANT-3 and RADIANT-4CabozantinibCABINET (Alliance A021602)Lutetium-177 dotatatePeptide receptor radionuclide therapy (PRRT)Capecitabine + temozolomide (CAPTEM)	NCCN Guidelines: Neuroendocrine and Adrenal Tumors	95

Other settings

Subgroup	Setting	Approach	Products and trials	Guideline	Evidence
All comers	Hormone syndromes	Somatostatin analogues for carcinoid syndrome; steroidogenesis inhibitors or resection for ectopic ACTH.	Somatostatin analogues (octreotide, lanreotide)Carcinoid syndrome and carcinoid heart disease	NCCN Guidelines: Neuroendocrine and Adrenal Tumors	81

Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.