What would be your next step in management for a patient with oligometastatic colon NEC who only achieved stable disease after 4 cycles of carboplatin/etoposide?

There are essentially 2 options here: 1) To take a therapy break; 2) To continue.

Resection is only considered for highly selected cases of NEC and almost never for metastatic disease as early recurrence is the rule. I am not the only one who has noticed that the ORR and likely OS to platinum/etoposide in extrapulmonary NECs is inferior to what is seen in SCLC. That is not surprising as the genomics are very different. Colorectal NECs have genomics that are more similar to CRC than SCL so differe...