Real-world experience managing unresectable or metastatic small cell carcinoma of the prostate

Abstract

Introduction: Unresectable and metastatic small cell carcinoma of the prostate (SCPC) is a rare and aggressive disease that is under-represented in clinical trials. We carried out a retrospective chart review of metastatic or unresectable SCPC patients at British Columbia (BC) Cancer centers, studying diagnosis and treatment patterns. Methods: Drug dispensing records from the six BC Cancer centers were obtained from 2002–2017. For each patient, information was collected on baseline information prior to therapy, and for each line of treatment. Treatments at each line were compared regarding time to progression and overall survival by Kaplan-Meier curves. Results: Forty-one patients received treatment; 65.6% had metastatic disease and 61% had pure small cell carcinoma. Median time from treatment to death was 10 months (95% confidence interval [CI] 6–16). Patients with initially prostate-confined disease had a better median overall survival (mOS) of 21 months (95% CI 13–34) compared to those with initially locally advanced (mOS 19 months, 95% CI 5–37) and metastatic disease (mOS 8 months, 95% CI 6–10) (log-rank p=0.0364). All patients received either cisplatin- or carboplatin-based combination chemotherapy as the first-line treatment and 36.7% received second-line therapy. Time to second-line therapy was eight months for those who presented with metastatic SCPC, compared to 13 months for those with initial non-metastatic SCPC. Conclusions: This single-province, multi-institution cohort reports data on unresectable and metastatic SCPC and highlights the poor prognosis of this rare disease entity.

Second-Line Systemic Therapy for Highly Aggressive Neuroendocrine Prostate Cancer

“…The disease rapidly progresses after a short-term response to first-line therapy. Only 37% of patients received second-line systemic therapy, and the time from first-line to second-line therapy was 8 months in metastatic NEPC in the real world (20). Effective second-line and beyond therapies are mandatory to improve the survival of patients with NEPC.…”

Effect of chemotherapy alone or combined with immunotherapy for locally advanced or metastatic genitourinary small cell carcinoma: a real-world retrospective study

“…Patients with distant metastases had a median survival of 5 to 8.4 months [ 9 , 10 ]. Meanwhile, approximately 60% of small cell prostate cancer patients present with metastases [ 11 ], with a median survival and 5-year survival rate of 9.0 months and 6.4%, respectively [ 8 ]. Unfortunately, the survival time of the kidney performed poorly in each SEER stage [ 8 ].…”