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Review
. 2020 Dec 16;12(12):3792.
doi: 10.3390/cancers12123792.

Neuroendocrine and Aggressive-Variant Prostate Cancer

Nicholas Spetsieris  1 , Myrto Boukovala  1 , Georgios Patsakis  2 , Ioannis Alafis  1 , Eleni Efstathiou  1
Affiliations
Review

Neuroendocrine and Aggressive-Variant Prostate Cancer

Nicholas Spetsieris et al. Cancers (Basel). .

Abstract

In prostate cancer, neuroendocrine (NE) differentiation may rarely present de novo or more frequently arises following hormonal therapy in patients with castration-resistant prostate cancer (CRPC). Its distinct phenotype is characterized by an aggressive clinical course, lack of responsiveness to hormonal therapies and poor prognosis. Importantly, a subset of CRPC patients exhibits an aggressive-variant disease with very similar clinical and molecular characteristics to small-cell prostate cancer (SCPC) even though tumors do not have NE differentiation. This aggressive-variant prostate cancer (AVPC) also shares the sensitivity of SCPC to platinum-based chemotherapy albeit with short-lived clinical benefit. As optimal treatment strategies for AVPC remain elusive, currently ongoing research efforts aim to enhance our understanding of the biology of this disease entity and improve treatment outcomes for our patients. This review is an overview of our current knowledge on prostate cancer with NE differentiation and AVPC, with a focus on their clinical characteristics and management, including available as well as experimental therapeutic strategies.

Keywords: aggressive variant prostate cancer; anaplastic prostate cancer; castration resistant prostate cancer; neuroendocrine prostate cancer; small-cell prostate cancer.

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Conflict of interest statement

E.E. has received research grant support, served on advisory, received honoraria and travel expenses from Sanofi-Genzyme, Janssen Pharmaceuticals, Astellas, Tolmar, Bayer, AstraZeneca, Oric Pharma, Pfizer, Merck, Takeda. N.S., M.B., G.P., I.A. have no conflicts of interest to report.

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