Research To Practice | Oncology Videos Extrapulmonary Neuroendocrine Carcinoma — An Interview with Dr Jonathan Strosberg on Current and Future Management (Companion Faculty Lecture)
Sep 19, 2025
In this engaging talk, Dr. Jonathan Strosberg, a leading gastrointestinal oncologist at Moffitt Cancer Center, delves into extrapulmonary neuroendocrine carcinomas (NECs). He explores the classification, grading, and mutational profiles of NECs, highlighting the current treatment paradigms, including the platinum-etoposide approach. Strosberg also discusses the emerging biomarker DLL3 and its potential in targeted therapies, along with innovative immunotherapy strategies and ongoing clinical trials aimed at improving patient outcomes in this challenging area of oncology.
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Poorly Differentiated NECs Are Distinctly Aggressive
- Poorly differentiated neuroendocrine carcinomas (NECs) are distinct from well-differentiated NETs and are uniformly aggressive with very high Ki-67.
- NECs often present metastatic and lack somatostatin receptor expression, unlike many NETs.
Extrapulmonary NEC Primary Sites
- About 10% of poorly differentiated NECs originate outside the lung and half of those come from the GI tract.
- Genitourinary sites account for many extrapulmonary NEC primaries including cervix and bladder.
Genomics Clarifies Gray-Zone Tumors
- High-grade gray-zone tumors can blur classification and often require NGS to clarify lineage and guide therapy.
- NECs frequently share mutations with organ-specific adenocarcinomas, suggesting common stem-cell origins.