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

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.

A total of 9 patients with histologically confirmed t-NEPC were reviewed.

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.

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.