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A deadly form of advanced prostate cancer is more common than experts previously thought.

A new study looked at about 200 men with prostate cancer that had spread and were resistant to standard treatment. It found that about 17 percent of the men had developed a deadlier subtype of prostate cancer called treatment-emergent small cell neuroendocrine prostate cancer.

“Clinical recognition of the emergence of small cell carcinoma during the usual progression of prostate cancer is increasing,” said Moffitt pathologist Dr. Jasreman Dhillon. The increase is largely attributed to the use of more effective androgen deprivation therapies in recent years.  This type of prostate cancer progresses rapidly and combinational chemotherapy is the only treatment option at this time.

The study’s findings suggest the deadly cancer subtype could also be successfully treated with targeted therapy, a type of treatment that is tailored to individual tumors.

Moffitt is already using a type of individualized treatment called adaptive therapy. It utilizes mathematical models to analyze a patient’s response to treatment to create a unique and constantly evolving treatment strategy.

Dr. Jingsong Zhang, a medical oncologist in Moffitt’s Genitourinary Oncology Program, is currently conducting a clinical trial of adaptive therapy for prostate cancer patients.

“The adaptive therapy trials at Moffitt aim to delay or prevent the emergence of the much aggressive treatment related to small cell neuroendocrine prostate cancer,” said Zhang. 

According to the American Cancer Society, almost 30,000 men will die from prostate cancer in 2018. Researchers believe increased recognition of small cell neuroendocrine prostate cancer could lead to more specific diagnoses, better treatment and higher survival rates in the future.