Peripheral T-cell repertoire alterations are common and affect outcome in large cell neuroendocrine lung carcinoma

Large cell neuroendocrine lung carcinoma (LCNEC) is a rare disease with poor prognosis and limited treatment options. Currently actionable genetic alterations are exceedingly uncommon in these patients, therefore alternative therapeutic approaches are urgently needed. Everolimus, an mTOR inhibitor with immunomodulatory and antiproliferative activity, in combination with carboplatin and paclitaxel proved a well-tolerated and effective first-line treatment for patients with metastatic LCNEC in the CRAD001KDE37 phase II trial. Immunologic parameters could be therapeutically relevant in this entity, but systematic studies are lacking.