Emerging trends in the evaluation and management of small cell prostate cancer: a clinical and molecular perspective.

INTRODUCTION: Prostatic small cell carcinoma (PSCC) is a rare, aggressive form of prostate cancer associated with poor clinical outcomes. It can arise de novo or in the setting of castrate resistant adenocarcinoma of the prostate. Current therapeutic interventions are based upon observations the PSCC responds similarly to small cell carcinoma of the lung. Standard treatment includes chemotherapy with cisplatin and etoposide, radiation therapy, and occasional extirpative management. Ongoing research into the molecular pathway behind the development of PSCC and potential interventions is resulting in the identification of multiple novel therapeutic targets. AREAS COVERED: A review of contemporary literature was undertaken to evaluate the histology, pathogenesis, evolution, current and novel treatment regimens, and upcoming methods of diagnosis of PSCC. To this end a literature search using terms, 'prostate small cell carcinoma', 'neuroendocrine prostate cancer', and derivations thereof was performed with a thorough review of the current literature. Expert commentary: Among current studies, AURKA inhibitors and PAPR1 inhibitors are exciting potential targets with early studies suggesting significant benefit. Continued research into the molecular underpinnings of PSCC is necessary to identify novel targets for early identification of patients with PSCC and to develop optimal treatment regimens.