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. 2024 Sep 1;7(6):459-462.
doi: 10.1002/iju5.12778. eCollection 2024 Nov.

A case of mixed neuroendocrine carcinoma-acinar adenocarcinoma: Utilization of triplet therapy for prostate cancer

Junichi Ikeda  1 , Hisanori Taniguchi  1 , Hiroki Takayama  1 , Yuki Masuo  1 , Takahiro Nakamoto  1   2 , Katsunori Uchida  2 , Hidefumi Kinoshita  1
Affiliations

A case of mixed neuroendocrine carcinoma-acinar adenocarcinoma: Utilization of triplet therapy for prostate cancer

Junichi Ikeda et al. IJU Case Rep. .

Abstract

Introduction: Neuroendocrine prostate cancer is an aggressive histological subtype of prostate cancer with a poor prognosis. Neuroendocrine prostate cancer is traditionally treated with cisplatin-based chemotherapy, similar to that used in treating small-cell lung cancer. However, the therapeutic effectiveness of chemotherapy for neuroendocrine prostate cancer has been limited. This case report describes a response to triplet therapy using darolutamide, androgen deprivation therapy, and docetaxel, which was administered in a patient with mixed neuroendocrine prostate cancer.

Case presentation: A 77-year-old man was newly diagnosed with mixed neuroendocrine prostate cancer. Serum prostate-specific antigen, neuron-specific enolase, and progastrin-releasing peptide levels were 62.2, 40.6, and 60.6 pg/mL, respectively. Multiple lymph node metastases were identified on a computed tomography scan, and bone scintigraphy revealed multiple bone metastases. The clinical stage was determined to be cT3bN1M1b. Ultimately, tumor size and serum markers decreased with triplet therapy.

Conclusion: We demonstrated the first case in which triplet therapy had been effective in the treatment of neuroendocrine prostate cancer.

Keywords: darolutamide; metastatic hormone‐sensitive prostate cancer; mixed neuroendocrine carcinoma–acinar adenocarcinoma; neuroendocrine prostate cancer; triplet therapy.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Microscopic images of a needle biopsy specimen. Hematoxylin and eosin staining images of neuroendocrine prostate cancer: low‐power view (a); high‐power view (b); positive PSA staining for acinar adenocarcinoma components (c); negative PSA staining for neuroendocrine carcinoma components (d); neuroendocrine carcinoma components show positive staining for synaptophysin (e), and chromogranin A (f); predominantly positive AR staining for neuroendocrine carcinoma components (g).
Fig. 2
Fig. 2
Bone scintigraphy revealed multiple bone metastases in the spine and pelvis.
Fig. 3
Fig. 3
Treatment course and tumor markers. Serum PSA and NSE levels decreased and remained at the nadir. The normal level of NSE is less than or equal to 16.3 ng/mL.
Fig. 4
Fig. 4
Tumor response to triplet therapy. The tumor in the cervical spine has shrunk significantly.
See this image and copyright information in PMC

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