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Prostate cancer recurring as small-cell carcinoma with a BRCA2 somatic mutation

Ryo Yabusaki1, Koji Yoshimura1, Keisei Taku2

  • 1Department of Urology Shizuoka General Hospital Shizuoka Japan.

IJU Case Reports
|November 7, 2022
PubMed
Abstract

Insights

Small-cell prostate cancer is aggressive. A BRCA2-positive case responded to PARP-2 inhibitor olaparib, showing potential for this targeted therapy in refractory disease.

Area of Science:

  • Oncology
  • Genitourinary Cancer
  • Prostate Cancer Research

Background:

  • Small-cell carcinoma of the prostate (SCPC) presents a poor prognosis with limited treatment options for refractory disease.
  • Standard treatments like combined androgen blockade were insufficient for this advanced prostate cancer.
  • Castration-resistant prostate cancer progression necessitates novel therapeutic strategies.

Observation:

  • A 68-year-old male patient with prostate cancer developed refractory disease.
  • Computed tomography revealed enlarged inguinal lymph nodes, and elevated neuron-specific enolase confirmed metastatic small-cell carcinoma.
  • Genetic testing identified a BRCA2 deletion in the tumor biopsy specimen.

Findings:

  • Initial cytotoxic chemotherapy provided only temporary improvement for the patient with advanced SCPC.
  • Administration of the PARP-2 inhibitor olaparib following identification of a BRCA2 deletion resulted in partial remission for 8 months.
  • This case highlights the potential efficacy of targeted therapy in BRCA2-mutated SCPC.

Implications:

  • PARP-2 inhibition, specifically with olaparib, shows promise as a treatment for patients with BRCA2-positive small-cell prostate cancer.
  • Targeted therapies based on genetic profiling may offer new avenues for managing refractory prostate cancer.
  • Further research into PARP inhibitors for SCPC is warranted to improve patient survival outcomes.
Keywords:
BRCA2 genePARP inhibitorprostate cancersmall‐cell carcinoma

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