Clinical Features of Treatment-related Neuroendocrine Prostate Cancer: A Case Series

Anticancer Res. 2020 Jun;40(6):3519-3526. doi: 10.21873/anticanres.14340.

Abstract

Background/aim: The development of treatment-related neuroendocrine prostate cancer (t-NEPC) is an increasing clinical concern. The objectives were to clarify the clinical features of t-NEPC.

Patients and methods: A total of 9 patients with histologically confirmed t-NEPC were reviewed.

Results: Of these 9 patients, 2 patients were diagnosed with t-NEPC by a histological examination without elevation in blood tumor marker levels. Immunohistochemistry revealed an acquired Rb loss in 5 patients. All patients were treated with platinum-based chemotherapy as first-line treatment and 6 patients received concurrent radiation therapy (RT). The median cancer-specific survival was 14.4 months, and 7 patients achieved an objective response. Patients with tumor-infiltrating CD8+ lymphocyte (CD8+-TILs) showed better response than those without CD8+-TILs.

Conclusion: We described the clinical features of histologically confirmed t-NEPC. In addition to the importance of biopsy, we showed that platinum-based chemotherapy plus RT had a favorable cytoreductive effect. Further clinical recognition and studies are needed.

Keywords: Neuroendocrine differentiation; neuron-specific enolase; platinum-based chemotherapy; small-cell prostate cancer; treatment-related neuroendocrine prostate cancer.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor
  • Combined Modality Therapy
  • Disease Management
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Grading
  • Neoplasm Staging
  • Neuroendocrine Tumors / diagnosis*
  • Neuroendocrine Tumors / etiology
  • Neuroendocrine Tumors / therapy*
  • Prostatic Neoplasms / diagnosis*
  • Prostatic Neoplasms / etiology
  • Prostatic Neoplasms / therapy*
  • Tomography, X-Ray Computed
  • Treatment Outcome

Substances

  • Biomarkers, Tumor