Atypical bronchial carcinoid (ABC): recurrence-free survival after resection and analysis of therapeutic interventions

Level: Level 2

Launch date: 1 March 2023

Principle investigators: Eric BAUDIN

Project description:

Background:

• Most bronchial carcinoids are diagnosed at stage I-II. Typical carcinoids (TC) represent 90% of this population. R0 resection of the tumor is achieved in 95% of cases.
• The recurrence rate mainly depends on the WHO classification and the TNM.
• The recurrence rate is higher in atypical carcinoids (AC): between 5 and 35% at 5 years.
• Unmet need: current studies which have analysed the post-operative follow-up of patients with atypical carcinoids are mainly retrospective and non-standardized in terms of imaging follow-up, questioning the current relapse figures, timing, and locations.
• Finally, the guideline does not recommend routine adjuvant treatment but a case-by-case discussion, mainly in atypical N-positive carcinoids.
• Future indication of adjuvant therapy may benefit from this kind of information.
• A randomised trial is not feasible in this setting due to the rarity of atypical carcinoids.

Aim:

Principal aims:

• Prospectively evaluation of recurrence-free survival at 5 and 10 years of patients with localized AC who benefit from a curative R0 resection
• Define of the anatomical sites of recurrence, the temporality, and the diagnostic methods

Secondary aims:

• Define prognostic factors for RFS, including Ki67 in the WHO classification
• Median RFS and OS
• Analyse the types of interventions and results (new R0 Status)
• Assess the prognostic role of local EBRT therapeutic intervention (vs no local intervention)
• Assess the prognostic role of systemic interventions (vs no systemic intervention) for atypical bronchial carcinoids
• Analyse the molecular profile and its added prognostic value according to the proposal of Alcala et al Nat Com 2019 (ancillary study)

Inclusion criteria:

• Atypical bronchial carcinoid histologically proven ,2015 WHO classification.
• Stage I-III UICC 2019
• R0 surgery < 6 months
• Patient ≥ 18 year old
• Standardized follow-up according to ESMO 2020 guidelines
• Patient who has agreed to participates.

Publication rules: Every participating institution will have 1 (co)-authorship, further participating persons of the same institution will be listed in the acknowledgement. If the number of co-authors has to be limited to a journals policy, the order will be determined according to the patient numbers recruited.

• The first author is the chairperson or PI of the study group of the study (designer/methodologist of the study).
• The second author is the best recruiter in terms of numbers and quality or the co-main author (if not the PI of the study).
• Subsequent author hierarchy is dependent on quality/quantity of recruitment/methodologist.
• The last author is the second chairperson/PI of the study (if among best recruiter).

E. Baudin from Gustave Roussy, who coordinates the study, will be shared senior author.