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

Junichi Ikeda; Hisanori Taniguchi; Hiroki Takayama; Yuki Masuo; Takahiro Nakamoto; Katsunori Uchida; Hidefumi Kinoshita

doi:10.1002/iju5.12778

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

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

Authors

Junichi Ikeda¹, Hisanori Taniguchi¹, Hiroki Takayama¹, Yuki Masuo¹, Takahiro Nakamoto^{1

2}, Katsunori Uchida², Hidefumi Kinoshita¹

Affiliations

¹ Department of Urology and Andrology Kansai Medical University Hirakata Osaka Japan.
² Department of Pathology Kansai Medical University Hirakata Osaka Japan.

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.