MKI67 and neuroendocrine carcinoma: For patients with advanced PD-EP-NEC, combination regimens such as irinotecan, 5-fluorouracil (5-FU) and folinic acid are a second-line treatment option currently used, without robust trial evidence.7 This combination has been recommended for patients with a NEC diagnosis with a Ki-67 ≥55%, whereas some literature recommends temozolomide-based combinations for those with a Ki-67 <55%.8 9 In devising treatment strategies for PD-EP-NEC, many refer to the extensive literature on high-grade NEC of the lung, for which docetaxel is a second-line therapy option.9