In the randomized phase III TOPIC-NEC trial, Etoposide and cisplatin (EP) showed comparable efficacy to irinotecan and cisplatin (IE) as first line therapy for patients with advanced #neuroendocrine carcinoma of the digestive System.

Median OS was 12.5 months in the EP arm and 10.9 months in the IP arm (HR= 1.04; P = .80). The median PFS was 5.6 months in the EP arm and 5.1months in the IP arm (HR, 1.06; 95% CI, 0.78-1.45). A subgroup analysis of OS demonstrated that EP produced more favourable OS in patients with poorly differentiated NEC of pancreatic origin (HR, 4.10; 95% CI, 1.26-13.31). EP arm was associated with more neutropenia (91.5% vs 53.7%), leukocytopenia (61.0% vs 30.5%), and febrile neutropenia (26.8% vs 12.2%)