My dad has high grade NEC primary pancreas with liver mets. Showed progression on carbo/etopo and with the tumor growth has been unable to eat so has gotten pretty weak. He has had one dose of niv/ipi. Has a low chance of working but if it does it could potentially mean close to full recovery. I have seen many success stories. There is a very helpful high grade neuroendocrine carcinoma support group on facebook also. Best wishes.