Table 2.

Medical therapy options for progressive, advanced/metastatic well differentiated lung neuroendocrine tumors.

Category	Drugs	Indication	Sequence of use*
SSA	Octreotide, lanreotide	TC or AC with strongly positive SSR	First line
mTOR inhibitors	Everolimus	TC or AC of any kind	First line
Temozolomide-based chemotherapy	Temozolomide +/– capecitabine	TC or AC with negative SSR and rapid progression	First or second line
Platinum-based chemotherapy	Cisplatin and etoposide	AC with negative SSR and rapid progression	First or second line
PRRT	177lu-OCTROTATE	TC or AC with strongly positive SSR	Second or third line

SSA, somatostatin analogue; TC, typical carcinoid; AC, atypical carcinoid; mTOR, mammalian target of rapamycin; SSR, somatostatin receptor; PRRT, peptide receptor radionuclide therapy.

^*There is no substantial evidence for the preferred regimen or sequence.