Kenmotsu H, Niho S, Tsuboi M, et al. - In patients with completely resected stage I-IIIA high-grade neuroendocrine carcinoma (HGNEC) of the lung, researchers ascertained that irinotecan plus cisplatin is more effective than etoposide plus cisplatin as postoperative adjuvant chemotherapy in this randomized, open-label, phase 3 study. Among 221 patients, 111 were administered etoposide plus cisplatin and 110 patients were administered irinotecan plus cisplatin. The 3-year RFS was 65.4% for etoposide plus cisplatin and 69.0% for irinotecan plus cisplatin at a median follow-up of 24.1 months. Grade 3-4 adverse events were more frequent in the etoposide plus cisplatin arm, with febrile neutropenia and neutropenia being the most common. Meanwhile, grade 3-4 anorexia and diarrhea were more frequently observed in the irinotecan plus cisplatin arm. Findings do not support the superiority of irinotecan plus cisplatin over etoposide plus cisplatin for improving relapse-free survival (RFS) in patients with completely resected HGNEC; etoposide plus cisplatin remains the standard treatment.