Characterization of prostate neuroendocrine cancers and therapeutic management: a literature review

Abstract

The exploration of the different pathways implicated in the neuroendocrine differentiation of prostate cancers is essential for the comprehension of castration-resistance mechanisms. It will enable the identification of optimal therapeutic strategies for which no recommendation is currently established. Inclusion in prospective clinical trials appears necessary to identify the adequate strategy.

Small Cell Carcinoma of the Prostate in an Elderly Patient: A Case Report and Review of the Literature

“…3,7,9 To date our knowledge of SCC of the prostate relies largely on retrospective institutional case series or larger retrospective database reviews (Table 1). 1,11-13 In a study by the University of Nebraska, 73.7% of patients with SCC of the prostate were diagnosed over the age of 65, and 39% were 75 or older when diagnosed. 12 Signs and symptoms often include obstructive uropathy, neurologic/constitutional symptoms, paraneoplastic syndromes, bone pain, hydronephrosis, abdominal pain, hematochezia, and hematuria depending on the involvement of malignancy.…”

Systemic Medical Treatment in Men with Metastatic Castration-Resistant Prostate Cancer: Recommendations for Daily Routine

“…Most probably, these aggressive variants develop due to transformation of androgen-sensitive into androgen receptor (AR)-independent prostate cancer as part of the adaptive resistance to AR-targeted therapies. Neuroendocrine and small cell carcinoma of the prostate are anaplastic variants which are diagnosed in about 10-20% of patients with CRPC [30,31,32,33]. It is evident that these subtypes of CRPC need different therapeutic approaches since AR-targeted therapies are basically ineffective and docetaxel exerts only modest activity.…”

“…Furthermore, serum concentrations of PSA, C-reactive protein (CRP), LDH, hemoglobin, alkaline phosphatase have been shown to correlate with response to therapy and survival [32,33,34]. Elevated LDH levels are thought to be reflective of the underlying tumor burden or an aggressive phenotype.…”

“…Aggressive, non-adenocarcinoma variants of prostate cancer are increasingly recognized in the clinic [30,31,32,33]. Most probably, these aggressive variants develop due to transformation of androgen-sensitive into androgen receptor (AR)-independent prostate cancer as part of the adaptive resistance to AR-targeted therapies.…”

Current Histopathologic and Molecular Characterisations of Prostate Cancer: Towards Individualised Prognosis and Therapies

“…As suggested by Sargos et al, "The exploration of the different pathways implicated in the neuroendocrine differentiation of prostate cancers is essential for the comprehension of castration-resistance mechanisms" [14].…”