Chemotherapy For Metastatic Grade 3 Poorly Differentiated NEuroendocrine Carcinoma Of GastroEnteroPancreatic And Unknown Primary

Inclusion Criteria: * Grade 3 neuroendocrine carcinoma or high grade MiNEN with a grade 3 poorly differentiated neuroendocrine carcinoma component ≥30% of gastro-entero-pancreatic or unknown primary * Poorly differentiated * Small cell or large cell or non-small cell or non- typeable * Metastatic disease * First-line, no prior therapy for metastatic disease, no prior use of carboplatin, oxaliplatin, cisplatin, etoposide, irinotecan and 5-fluorouracile * At least one measurable lesion as assessed by CT-scan or MRI according to RECIST 1.1 guidelines * Available tumor block * ANC ≥ 1.5x109/l, platelet ≥ 100x109/l and hemoglobin \> 8 g/dl * Total bilirubin ≤ 1.5N, AST ≤ 2.5N, ALT≤ 2.5N or AST/ALT ≤ 5N in case of liver metastases. * Age ≥ 18 years * ECOG Performance Status ≤ 1 * Signed and dated informed consent, and willing and able to comply with protocol requirements. * Women of childbearing potential, as well as men (who have sexual relations with women of childbearing potential) must agree to use an effective method of contraception throughout this study and during the 15 months following administration of the last dose of the study medicinal product * Patient who is a beneficiary of the Social security system Exclusion Criteria: * Grade 3 well differentiated neuroendocrine tumor according to WHO 2017 classification * Severe renal impairment (creatinine clearance less than 30 mL/min, MDRD) * Partial or complete Dihydropyrimidine Dehydrogenas…