Neuroendocrine differentiation in prostate cancer: novel morphological insights and future therapeutic perspectives

Biochim Biophys Acta. 2014 Dec;1846(2):630-7. doi: 10.1016/j.bbcan.2014.10.008. Epub 2014 Nov 4.

Abstract

Neuroendocrine prostate cancer (NEPC) is an aggressive variant of prostate cancer that commonly arises in later stages of castration resistant prostate cancer (CRPC) The detection of NEPC has clinical implications as these patients are often treated with platinum chemotherapy rather than with androgen receptor targeted therapies. The poor molecular characterization of NEPC accounts in part for the lack of disease specific therapeutics. Several mechanisms are involved in NE differentiation, including inflammation and autophagy, and may actually represent future therapeutic targets for advanced NEPC patients. Furthermore, a growing body of evidence suggests a potential role of circulating tumor cells in the early diagnosis and treatment of NEPC. Here we summarize the recent findings on NEPC pathogenesis and we discuss the ongoing clinical trials and future perspectives for the treatment of NEPC patients.

Keywords: Androgen deprivation therapy; Carcinoid; Drug resistance; Large cell neuroendocrine carcinoma; Neuroendocrine prostate cancer; Small cell carcinoma.

Publication types

  • Review

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use
  • Aurora Kinase A / physiology
  • Autophagy
  • Carcinogenesis
  • Cell Differentiation
  • Drug Resistance, Neoplasm
  • Humans
  • Male
  • Neoplastic Cells, Circulating
  • Neuroendocrine Cells / cytology*
  • Prostatic Neoplasms / drug therapy
  • Prostatic Neoplasms / etiology
  • Prostatic Neoplasms / pathology*

Substances

  • Angiogenesis Inhibitors
  • AURKA protein, human
  • Aurora Kinase A