Background: Neuroendocrine carcinoma of the prostate (NEPC) is a rare, androgen-independent variant of prostate cancer with increasing incidence of over the past few years. It commonly progresses rapidly and is associated with a poor prognosis. Based on a different tumor biology compared to adenocarcinomas of the prostate, standard therapeutic approaches for prostate cancer are ineffective. To date, no specific treatment for NEPC exists.
Objectives: The purpose of this work is to provide an overview of current histopathologic characteristics, histomorphologic classifications, and current as well as future treatment options for NEPC.
Materials and methods: The literature was reviewed and clinical trials focusing on the above mentioned objectives are discussed.
Results: Current histomorphologic classifications aim to differentiate between NEPC including its variants and neuroendocrine transdifferentiated adenocarcinoma of the prostate. Regarding conventional chemotherapy, platinum-based schemes are still widely used. Antiangiogenetic drugs represent potential alternatives and are currently under clinical investigation.
Conclusions: Histomorphological subtypes distinguish themselves in terms of aggressiveness, prognosis, and preferred therapeutic approaches. Treatment of NEPC differs fundamentally compared to adenocarcinoma of the prostate. There is only limited data available for the treatment of NEPC.
Keywords: Adenocarcinoma; Histomorphology; Small cell prostate cancer; Transdifferentiation, neuroendocrine; Tumors, neuroendocrine.