Would you consider adding immune checkpoint blockade to platinum + etoposide for metastatic high-grade large cell neuroendocrine tumor of the GI tract?

The addition of IO to first-line platinum/etoposide would primarily be an extrapolation of data from small cell lung cancer trials while awaiting the results of the ongoing SWOG 2012 trial being led by Dr. David Zhen (NCT05058651).

We have hints of limited activity of single-agent checkpoint inhibitors IO in GI NEC either alone or in combination with chemotherapy in later lines of therapy:

a) Vijayvergia et al., PMID 32152503:

29 patients with G3NENs of which 24 were GEP-NEC. Patients were treated...