Neuroendocrine and small-cell prostate cancer: lines of therapy
4 standard-of-care settings across 1 lines and 2 biomarker subgroups. Rows come from the cancer page's standard of care; the grid places each on its line and subgroup.
Other settings
| Subgroup | Setting | Approach | Products and trials | Guideline | Evidence |
|---|---|---|---|---|---|
| All comers | Recognition and biopsy | Biopsy any progression with low PSA, visceral metastases or PSMA-negative FDG-avid lesions; test for mismatch repair deficiency (pembrolizumab) and HRR genes. | 98 | ||
| All comers | Trials | DLL3 T-cell engagers (tarlatamab), EZH2 inhibitors and aurora kinase inhibitors against the lineage switch; lurbinectedin borrowed from small-cell lung cancer. | 85 | ||
| HR-positive | Small-cell or predominantly neuroendocrine | Cisplatin or carboplatin with etoposide, as for small-cell lung cancer; continue androgen deprivation; brain imaging. | NCCN Guidelines: Prostate Cancer | 95 | |
| HR-positive | Mixed adenocarcinoma and neuroendocrine, or aggressive variant | Carboplatin plus docetaxel or cabazitaxel, then platinum with etoposide; clinical trial enrolment preferred. | NCCN Guidelines: Prostate Cancer | 93 |
Lines and subgroups are parsed from the setting text of each standard-of-care row and can misclassify an unusual phrasing; the row’s own setting is always shown. Guideline chips reflect the NCCN category and ESMO-MCBS grade recorded on the cancer page, checked on its stated date. Not medical advice.