Are there any preferred chemotherapy regimens for Stage IV NUT carcinoma?

We have a current stage IV NUT carcinoma patient. With permission, I am paraphrasing my discussions with Drs. Christopher French and Dr. Geoffrey Shapiro from Dana Farber Cancer Institute.

There is no "standard" first-line chemotherapy regimen. However, in fit patients, the current recommendation at DFCI is ifosfamide-based treatment based on Scandinavian data. However, other regimens involving platinum, taxane, or anthracyclines are acceptable. If coverage will allow, the addition of an HDAC i...

Any directed debulking therapy - surgical or RT - always more certain than systemic therapy. I would not entertain IO alone however, chemo-IO is not unreasonable based on case reports. Mechanistically, I struggle to believe IO to be a key component of the regimen, given these tend to be genomically pure fusion driven tumors and the rest of these in NSCLC are IO refractory (ALK, ROS1, for example); however, given the window of opportunity is small with this disease, chemo-IO (plt-tax-IO) is very ...