Emerging Insights in Small-Cell Carcinoma of the Genitourinary Tract: From Diagnosis to Novel Therapeutic Horizons.
Ross S LiaoHui Ting RuanAlbert JangMelissa HuynhRosa Nadal RiosJean H Hoffman-CensitsShuanzeng WeiOmar Y MianPedro C BarataPublished in: American Society of Clinical Oncology educational book. American Society of Clinical Oncology. Annual Meeting (2024)
Small-cell carcinomas (SCCs) of the genitourinary (GU) tract are rare malignancies with high metastatic potential. The most common primary sites are the bladder and prostate, but case reports of primary SCC of the kidney, ureter, and urethra also exist. The majority of patients present with gross hematuria, irritative or obstructive urinary symptoms, and symptoms of locoregionally advanced or metastatic disease at initial presentation. SCC of the bladder presents with nodal or metastatic involvement in the majority of cases and requires the use of platinum-based chemotherapy in combination with surgery and/or radiation. SCC of the prostate is most commonly seen in the metastatic castrate-resistant setting, and aggressive variant disease presents with a greater propensity for visceral metastases, osteolytic lesions, and relatively low serum prostate-specific antigen for volume of disease burden. Multiple retrospective and prospective randomized studies support the use of a multimodal approach combining platinum-based systemic therapy regimens with radiation and/or surgery for localized disease. This evidence-based strategy is reflected in multiple consensus guidelines. Emerging data suggest that small-cell bladder and prostate cancers transdifferentiate from a common progenitor of conventional urothelial bladder carcinoma and prostatic acinar adenocarcinoma, respectively. Areas of active basic research include efforts to identify the key genetic and epigenetic drivers involved in the emergence of small cell cancers to exploit them for novel therapies. Here, we review these efforts, discuss diagnosis and currently supported management strategies, and summarize ongoing clinical trials evaluating novel therapies to treat this rare, aggressive GU cancer.
Keyphrases
- squamous cell carcinoma
- prostate cancer
- small cell lung cancer
- urinary tract
- spinal cord injury
- clinical trial
- cell therapy
- minimally invasive
- benign prostatic hyperplasia
- single cell
- newly diagnosed
- coronary artery bypass
- high grade
- ejection fraction
- insulin resistance
- stem cells
- mesenchymal stem cells
- pain management
- case report
- double blind
- type diabetes
- data analysis
- sleep quality
- radical prostatectomy
- big data
- study protocol
- cross sectional
- patient reported outcomes
- depressive symptoms
- chronic pain
- quality improvement
- case control
- smoking cessation
- squamous cell