Department of Urology, Mayo Clinic, Rochester, MN, USA.
Expert Rev Anticancer Ther. 2023 Feb;23(2):177-185. doi: 10.1080/14737140.2023.2173174. Epub 2023 Feb 3.
Neuroendocrine prostate cancer (NEPC) is an aggressive form of prostate cancer frequently seen after prolonged treatment of castration resistant prostate cancer (CRPC). NEPC has become increasingly prevalent over the last 20 years, with a poor prognosis caused by a late diagnosis and limited treatment options. Recent advances in PET/CT imaging and targeted radioimmunotherapy are promising, but more research into additional treatment options is needed.
The aim of this review is to analyze the current imaging and treatment options for NEPC, and to highlight future potential treatment strategies. A Pubmed search for 'Neuroendocrine Prostate Cancer' was performed and relevant articles were reviewed.
The recent FDA approval and success of 177 PSMA Lutetium in CRPC is promising, as 177 Lutetium could potentially be paired with a NEPC specific biomarker for targeted therapy. Recent laboratory studies pairing DLL3, which is overexpressed in NEPC, with 177 Lutetium and new PET agents have showed good efficacy in identifying and treating NEPC. The success of future development of NEPC therapies may depend on the availability of 177 Lutetium, as current supplies are limited. Further research into additional imaging and treatment options for NEPC is warranted.
神经内分泌前列腺癌（NEPC）是一种侵袭性前列腺癌，常发生于去势抵抗性前列腺癌（CRPC）长期治疗后。在过去的 20 年中，NEPC 的发病率越来越高，由于诊断较晚且治疗选择有限，预后较差。最近在 PET/CT 成像和靶向放射免疫治疗方面的进展令人鼓舞，但仍需要更多的研究来探索其他治疗选择。
本综述旨在分析 NEPC 的当前影像学和治疗选择，并强调未来潜在的治疗策略。对“Neuroendocrine Prostate Cancer”进行了 Pubmed 搜索，并对相关文章进行了综述。
最近 FDA 批准和 177 PSMA 镥在 CRPC 中的成功令人鼓舞，因为 177 镥有可能与 NEPC 特异性生物标志物联合用于靶向治疗。最近的实验室研究将在 NEPC 中过表达的 DLL3 与 177 镥和新的 PET 剂配对，在识别和治疗 NEPC 方面显示出良好的疗效。未来 NEPC 治疗方法的成功可能取决于 177 镥的供应情况，因为目前的供应有限。需要进一步研究 NEPC 的其他影像学和治疗选择。
