When, if ever, do you use capecitabine/temozolomide in metastatic high grade neuroendocrine carcinoma?

CAPTEM has a relatively minimal role in the management of neuroendocrine carcinoma (NEC) and is almost exclusively used in later lines of therapy after first-line platinum/etoposide. In general, second-line therapy of NEC is ineffective and a retrospective study of 64 patients receiving various regimens showed a median PFS of only 2.3 months and median OS of 6.2 months.

A multicenter retrospective study of 136 patients, both NEC and well-differentiated G3 NET treated with temozolomide-based chem...