Background
tumours of the digestive system, NEC, neoplasms, GEP-NET G3, tumours of the digestive system [
NEOPLASMS, NEUROENDOCRINE CARCINOMA, GASTROENTEROPANCREATIC NEUROENDOCRINE NEOPLASM, NEUROENDOCRINE TUMOURS
Gastroenteropancreatic neuroendocrine neoplasms (GEP-NEN) are a heterogeneous group of neoplasms differing in biological behaviour, treatment benefit, and survival. The 2019 WHO classification of tumours of the digestive system separates high-grade (HG) GEP-NEN with a Ki-67 index above 20% into two distinct entities; well-differentiated neuroendocrine tumours, NET G3, and poorly differentiated neuroendocrine carcinoma, NEC [Traditionally patients with both GEP-NET G3 and GEP-NEC have predominantly received platinum-based chemotherapy as first-line palliative treatment [Recognising the unmet need for clinical trial data to improve the treatment of advanced HG GEP-NEN with Ki-67 21–55% and demonstrated efficacy of both everolimus and temozolomide in GEP-NET G1-2, this study was conducted to evaluate the efficacy and safety of the combination of everolimus and temozolomide as a first-line treatment for this patient group. Pathological reclassification was performed to separate NET G3 and NEC patients according to the WHO 2019 classification of tumours of the digestive system [