Hello all!
Mike was dx with NEPC this past summer. You can view his history in my profile. He recently completed 6 cycles of carboplatin+etoposide+tecentriq. Recent CT scans completed after his last cycle show the mets are stable with a small amount of improvement. While we are celebrating this news, his oncologist is looking ahead. Following along with treating this like a Small Cell Lung Cancer she is suggesting radiation next. She has mentioned radiation to the prostate and to the brain as a preventative. We had a baseline MRI of the brain complete at the start of his current treatment with no mets discovered. Immunotherapy is ongoing every 3 weeks. We met with a radiation oncologist back in September and the conversation was geared toward radiation for symptom management. I was under the impression that neuroendocrine tumors don’t respond to radiation, with some evidence indicating it may promote PCa transformation into NEPC. Here is some literature that I was able to find suggesting it is not effective for extensive stage disease. We are with the Cleveland Clinic Taussig Center. I would like to consult with Dr. Beltran with Dana Farber in Boston. She has studied NEPC extensively. I would love to hear your thoughts.
Nikki
2 years into Stage 4 Treatment 
Diagnosis of NEPC- Low PSA High Chromogranin A
Treatment in Germany 
PSA rise during/after consolidation radiation 
PSMA PET Scan Frequency?
