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How do you treat localized prostate cancer with neuroendocrine differentiation?
Answer from: Medical Oncologist at Academic Institution
Most hybrid or pure NEPC tumors lack PSMA expression as only 1/3 of metastatic NEPC tumors are PSMA PET+ and expression is typically very heterogeneous. For this reason, an FDG PET/CT would likely be a better staging test for this aggressive variant of prostate cancer. If this is also N0M0, RP is my...
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Answer from: Medical Oncologist at Community Practice
Neuroendocrine carcinoma of the prostate may represent a subset of prostate cancer phenotypes which may be linked to resistance to androgen receptor signaling inhibition and aggressive tumor behavior. Based on morphological characteristics, proliferative index, and grade, neuroendocrine carcinoma of...
Answer from: Medical Oncologist at Community Practice
This is an interesting question. The data in high-risk localized prostate cancer does not subclassify patients based on neuroendocrine differentiation. Even if we look at data from STAMPEDE for localized high-risk prostate cancer which had a large number of high-risk patients predominantly with Glea...
Answer from: Radiation Oncologist at Community Practice
That is a great question. What is the role of prostatectomy, SBRT, and/or pelvic nodal irradiation? Is Lupron and abiraterone adequate systemic therapy? Clearly, the patient's risk of systemic disease is high but local (and regional?) control in the absence of visible disease on PSMA PET or CT still...