Emerging molecular pathways and targets in neuroendocrine prostate cancer

Small cell prostate cancer remains a poorly understood, aggressive form of prostate cancer that develops either de novo or in the setting of castrate resistant adenocarcinoma of the prostate. Frequently these tumors are advanced and are challenging to treat using current modalities. Research into molecular abnormalities that drive the development and propagation of small cell prostate cancer is ongoing and has the potential to revolutionize the management of these patients. Current research into the role of N-myc (NMYC) is altering our understanding of this aggressive disease. A recent study demonstrated that NMYC over expression can lead to development of invasive and androgen castrate resistant small cell prostate cancer. Furthermore, this research went on to show that NMYC over expression can lead to transformation of prostate adenocarcinoma into small cell prostate cancer. Finally, recent research has explored the role of aurora kinase A (AURKA) inhibitors in disrupting the NMYC pathway and providing a potential therapeutic target for treatment of small cell prostate cancer. As research continues to advance our understanding of the molecular underpinnings of small cell prostate cancer, we will be able to develop novel therapeutic targets and agents in order to better treat this aggressive form of prostate cancer.