This subgroup of neuroendocrine carcinomas is characterized by expression of ASCL1 (Achaete-scute homolog 1 is a member of the bHLH transcription factors and is required for proper development of pulmonary neuroendocrine cells) and RET, is associated with a poor prognosis and occurs predominantly in smoker patients [121]. The gene discussed is ASCL1; the disease is neuroendocrine carcinoma.