Clinical characteristics and treatment of patients with small cell prostate cancer: analysis of a real-world cohort from an oncology database

Corbin J Eule; Adam Warren; Elizabeth Molina Kuna; Tyler P Robin; Boris Gershman; Simon P Kim; Thomas W Flaig

doi:10.1038/s41391-024-00914-z

Clinical characteristics and treatment of patients with small cell prostate cancer: analysis of a real-world cohort from an oncology database

Prostate Cancer Prostatic Dis. 2024 Nov 21. doi: 10.1038/s41391-024-00914-z. Online ahead of print.

Authors

Corbin J Eule¹, Adam Warren², Elizabeth Molina Kuna², Tyler P Robin³, Boris Gershman⁴, Simon P Kim⁵, Thomas W Flaig⁶

Affiliations

¹ University of Colorado Cancer Center, Division of Medical Oncology, Department of Medicine, Aurora, CO, USA.
² University of Colorado Cancer Center, Population Health Shared Resource, Aurora, CO, USA.
³ University of Colorado Cancer Center, Department of Radiation Oncology, Aurora, CO, USA.
⁴ Beth Israel Deaconess Medical Center, Division of Urologic Surgery, Boston, MA, USA.
⁵ University of Colorado Cancer Center, Department of Surgery, Division of Urology, Aurora, CO, USA.
⁶ University of Colorado Cancer Center, Division of Medical Oncology, Department of Medicine, Aurora, CO, USA. [email protected].

PMID: 39572637
DOI: 10.1038/s41391-024-00914-z

Abstract

Background: Small cell prostate cancer (SCPC) is a rare, aggressive disease with limited clinical data to guide treatment. In this retrospective study, we evaluated clinical, treatment, and outcomes data for patients with SCPC.

Methods: Patients with SCPC were selected from CancerLinQ Discovery^®, a United States-based de-identified clinical database derived from the electronic health records of over 60 medical oncology organizations. A diagnosis of SCPC was made based on a tumor histology code of small cell carcinoma. The primary outcome of this study was assessing first-line systemic therapy within 1 year of diagnosis of SCPC.

Results: 74 patients with SCPC who received systemic therapy between 2010-2023 were identified. The majority had documented metastatic disease (45 patients, 60.8%) and a low PSA (median 2.8 ng/dL) at SCPC diagnosis. Platinum chemotherapy plus etoposide was the most common systemic treatment (62, 83.8%) and carboplatin plus etoposide was the most common regimen (42, 56.8%) used in the first line. Median overall survival (OS) was 8.3 months for patients with metastatic SCPC. Patients treated with cisplatin plus etoposide had improved survival versus those receiving carboplatin plus etoposide (odds ratio 3.15, 95% CI 1.57-6.30; p = 0.001). 45.9% of patients with SCPC received second-line systemic therapies, which were highly varied.

Conclusions: This contemporary real-world data represent one of the largest descriptions of the treatment of SCPC. Clear consensus on the optimal systemic therapy for SCPC is lacking. While additional research is needed, real-world practice patterns can serve as a resource when considering a treatment approach for this rare disease.