ASCO 2023 | Neuroendocrine vs small cell prostate cancer: distinguishing entities and treatment considerations

Ravi Amrit Madan, MD, National Cancer Institute, Bethesda, MD, highlights the importance for clinicians to distinguish between neuroendocrine prostate cancer and small cell prostate cancer. Small cell prostate cancer has a rapid and aggressive course and typically requires a platinum-based regimen. However, neuroendocrine staining can be observed in various stages of prostate cancer, including adenocarcinoma with neuroendocrine features. Dr Madan suggests clinicians to consider using standard therapies and monitoring for progression in patients with neuroendocrine staining, rather than immediately resorting to small cell regimens. The challenge lies in determining the point at which to transition from standard therapies to more aggressive approaches. Misdiagnosis of neuroendocrine prostate cancer can lead to unnecessary abandonment of standard care. Further research is needed to improve the treatment of small cell prostate cancer and accurately identify patients who would benefit from specific regimens.This interview took place at the American Society of Clinical Oncology (ASCO) 2023 Annual Congress in Chicago, IL.

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