{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T06:16:02Z","timestamp":1783577762451,"version":"3.55.0"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T00:00:00Z","timestamp":1783555200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      <jats:italic>De novo<\/jats:italic>\n                      neuroendocrine prostate cancer is an aggressive, androgen receptor-independent subtype of prostate cancer with poor prognosis. Central nervous system (CNS) metastases from\n                      <jats:italic>de novo<\/jats:italic>\n                      neuroendocrine prostate tumors are rare, and evidence guiding treatment is limited. Lurbinectedin, approved for small cell lung cancer (SCLC), has shown activity in neuroendocrine tumors, though CNS-specific data remain sparse.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 57-year-old man presenting with tenesmus, dyschezia, and urinary retention was diagnosed with high-grade neuroendocrine prostate carcinoma with low prostate-specific antigen (PSA) and high proliferative index. Genomic profiling revealed alterations in ATM and BRCA2 and was negative for Rb1 and TP53. He achieved complete systemic response following platinum-based chemoradiotherapy and immunotherapy but later developed multifocal brain metastases with suspected leptomeningeal involvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention and outcomes<\/jats:title>\n                    <jats:p>After progression on whole-brain radiotherapy and topotecan, lurbinectedin was initiated. Imaging demonstrated marked intracranial response, including resolution and reduction of multiple lesions. Disease progression occurred after six cycles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This case underscores similarities between neuroendocrine prostate carcinoma and SCLC, supporting the use of SCLC-based therapies. The observed response suggests that lurbinectedin may have clinically meaningful CNS activity, even after failure of standard CNS-directed treatments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Lurbinectedin may be a therapeutic option in CNS-dominant neuroendocrine prostate carcinomas. Further studies are needed to better define its intracranial efficacy and durability of response.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1840883","type":"journal-article","created":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T05:36:31Z","timestamp":1783575391000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Lurbinectedin in treating CNS metastases from small cell neuroendocrine prostate cancer\u2014a case report"],"prefix":"10.3389","volume":"16","author":[{"given":"Avani","family":"Gunuganti","sequence":"first","affiliation":[{"name":"Rice University","place":["Houston, TX, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vedin","family":"Barve","sequence":"additional","affiliation":[{"name":"Department of Medicine San Antonio, The University of Texas Health Science Center","place":["San Antonio, TX, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William J.","family":"Kelly","sequence":"additional","affiliation":[{"name":"Department of Medicine San Antonio, The University of Texas Health Science Center","place":["San Antonio, TX, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vijay","family":"Gunuganti","sequence":"additional","affiliation":[{"name":"Texas Oncology","place":["San Antonio, TX, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Brenner","sequence":"additional","affiliation":[{"name":"Department of Medicine San Antonio, The University of Texas Health Science Center","place":["San Antonio, TX, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,9]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1002\/pros.24664","article-title":"Diagnosis and management of neuroendocrine 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