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Would you add atezolizumab to carboplatin + etoposide for small cell/neuroendocrine prostate cancer?

Treatment for small cell/neuroendocrine prostate is extrapolated from data on small cell lung cancer. It now appears that Carboplatin + Etoposide + Atezolizumab followed by maintenance Atezolizumab is the new first-line treatment for extensive-stage small cell lung cancer based on the phase III study IMpower133 that showed OS and PFS benefit over Carboplatin + Etoposide + Placebo. https://www.nejm.org/doi/full/10.1056/NEJMoa1809064
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Medical Oncology · Duke University School of Medicine
Answered on

This is an excellent question. While small cell lung cancer and small cell prostate cancer share common genomics (RB1, TP53 mutation or loss for example) and histology, they differ in many important ways including divergent evolution from AR positive disease in many patients with transformed disease...

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