{"entity":{"id":"paper-aggarwal-t-sccpc-jco-2018","kind":"paper","name":"Clinical and genomic characterisation of treatment-emergent small-cell neuroendocrine prostate cancer","aka":[],"tldr":"Biopsying metastases in men progressing on modern hormone therapy found small-cell neuroendocrine prostate cancer in 17 percent, with a median survival under three years, showing how commonly the lineage switch occurs and why biopsy at progression matters.","summary":"Prospective multi-institutional study of 202 men with metastatic castration-resistant prostate cancer who underwent metastatic biopsy, with histological and transcriptomic classification of treatment-emergent small-cell neuroendocrine prostate cancer.\n\nSmall-cell neuroendocrine histology was found in 17 percent, associated with worse overall survival (36.6 versus 44.5 months), a distinct expression signature and low androgen receptor signalling; serum markers such as chromogranin were unreliable.","asOf":"2026-09-17","links":[{"label":"J Clin Oncol 2018","url":"https://doi.org/10.1200/JCO.2017.77.6880"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/29985747/"}],"tags":[],"related":["prostate-roadmap","paper-mu-sox2-lineage-plasticity-science-2017","idea-prostate-plasticity-surveillance-before-it-is-neuroendocrine"],"cancers":["prostate-nepc","prostate"],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":["neuroendocrine-differentiation"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["jco"],"dependsOn":[],"notes":[],"journal":"Journal of Clinical Oncology","year":2018,"doi":"10.1200/JCO.2017.77.6880","pmid":"29985747","authors":"Aggarwal R, Huang J, Alumkal JJ, et al.","paperType":"observational","findings":["Treatment-emergent small-cell neuroendocrine prostate cancer in 17 percent of biopsied patients.","Median overall survival 36.6 vs 44.5 months for adenocarcinoma."],"whatItMeans":"Biopsy of progressing lesions, especially with low PSA or visceral spread, is recommended to detect neuroendocrine transformation and switch to platinum-based therapy or trials.","caveats":["Selected patients undergoing biopsy at academic centres."],"changedPractice":true,"participants":202},"route":"/key-papers/paper-aggarwal-t-sccpc-jco-2018/","neighbours":{"roadmap":[{"id":"prostate-roadmap","kind":"roadmap","name":"Prostate cancer roadmap: from Huggins and the discovery that a cancer can depend on a hormone, through the PSA epidemic and what it cost, the androgen receptor drugs, the DNA repair subset and PSMA, to a 2032 registry watch","route":"/roadmaps/prostate-roadmap/"}],"paper":[{"id":"paper-mu-sox2-lineage-plasticity-science-2017","kind":"paper","name":"SOX2 promotes lineage plasticity and antiandrogen resistance in TP53- and RB1-deficient prostate cancer","route":"/key-papers/paper-mu-sox2-lineage-plasticity-science-2017/"}],"idea":[{"id":"idea-prostate-plasticity-surveillance-before-it-is-neuroendocrine","kind":"idea","name":"Watch for the cancer changing cell type before the biopsy says neuroendocrine, and act on it","route":"/ideas/idea-prostate-plasticity-surveillance-before-it-is-neuroendocrine/"}],"cancer":[{"id":"prostate-nepc","kind":"cancer","name":"Neuroendocrine and small-cell prostate cancer","route":"/cancers/prostate-nepc/"},{"id":"prostate","kind":"cancer","name":"Prostate cancer","route":"/cancers/prostate/"}],"term":[{"id":"neuroendocrine-differentiation","kind":"term","name":"Neuroendocrine differentiation in prostate cancer","route":"/terms/neuroendocrine-differentiation/"}],"journal":[{"id":"jco","kind":"journal","name":"Journal of Clinical Oncology","route":"/journals/jco/"}]}}