Neuroendocrine Diferenciation

[Noel91]

After covid Diagnosis father was detected to have three mets on the lung( he had one at first but se had to wait because covid diagnosis) .One if them was on a lung lymph node. MO decided he had Neuroendocrine lung cancer after analyzing It. He have had two dosis of carboplatin chemo when they realized It was not lung cancer but a neuroendocrine diferenciation from the prostate( after the genetic test I have been requesting since I started in this forum 3 years ago)After this two rounds two of the tumors "dissapear" and the doctor has decided to shrinck the small tumour with some radiotherapy meanwhile he continue with zytiga(Bone mets remain invisible on PET). Asking this group to see if anyone has gone through something similar.At this point I do not really know what yo expect.How long do you think we have left together? Always really thankful with all the support at this group.Big hugs from Spain

[Tall_Allen]

They do not detect that with a genomic test - only with IHC. Also important to know if it expresses PD-L1.

[Noel91 in reply to Tall_Allen]

I do not really know and MO is really reticent to answer questions... i just know they detected It using the Cromogranin A and comparing It with the prostate cancer sample from his RP in 2018. they decided It is genetical. What would happen If It expressses PD-L1?( I Will check on the tests) thank you

[Tall_Allen in reply to Noel91]

A stain for Chromogranin A is just one of several stains they have to use - it is not enough on its own to detect neuroendocrine PCa (NEPC). Many non-NEPC cancer cells also express Chromogranin A. They should also test for neuron-specific enolase (NSE), synaptophysin, DLL-3, and CD56. Not all labs are equipped to do this. The Wang Lab at Duke University can provide a full work-up. While NEPC represents a change in the genomics of the cancer, the test they use (immunohistochemistry, IHC) tests for proteins expressed rather than genes.

If it expresses PD-L1, it may be vulnerable to immunotherapy with certain drugs like Keytruda, Opdivo, Imfinzi, or Tecentriq.

[petercraig2]

Hello Noel91Sorry to hear about the complications you are having which seems like prostate cancer tumors in the lungs.

Unfortunately my experience withe radiotherapy was 35 sessions to the prostate bed so probably not relevant.

However I have subsequently learned of a radiation therapy called SBRT. That uses a higher dosage, very focused and reduced number of sessions. This has proven very effective on prostate cancer in the prostate itself but don't know if has been used on associated metastatic tumors.

All I can suggest is asking the question of your medical oncology team.

Best of luck

Peter