{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T17:10:15Z","timestamp":1790097015474,"version":"4.0.1"},"reference-count":79,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T00:00:00Z","timestamp":1790035200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int. J. Mol. Sci.","IJMS"],"abstract":"<jats:p>De novo small-cell neuroendocrine prostate cancer (SCNE PC) is a rare and highly aggressive subtype of prostate cancer with limited treatment options. BRCA2 alterations may increase sensitivity to platinum-based chemotherapy and PARP inhibition; however, evidence regarding their clinical relevance in SCNE PC is limited. We present two cases of de novo SCNE PC with distinct BRCA2 alterations. Both patients presented with a similarly extensive disease burden and initially received carboplatin and etoposide (CE), but their clinical courses differed markedly. Patient 1 developed brain metastases three months after completing six cycles of CE and died shortly after rechallenge with CE. In contrast, Patient 2 responded to repeated CE rechallenges, followed by short-term disease control with topotecan and 18 months of disease control with the PARP inhibitor olaparib. He subsequently developed leptomeningeal carcinomatosis and died shortly thereafter, with an overall survival of 5 years and 8 months. These cases illustrate the highly aggressive clinical course of de novo SCNE PC. Despite the potential predictive value of BRCA2 alterations, they may be associated with a higher incidence of brain metastases.<\/jats:p>","DOI":"10.3390\/ijms27198453","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T13:32:12Z","timestamp":1790083932000},"page":"8453","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Enemy of My Enemy: Two Cases of De Novo Metastatic Small-Cell Neuroendocrine Prostate Cancer with BRCA2 Alterations and Brain Metastases"],"prefix":"10.3390","volume":"27","author":[{"given":"Mads Fallesen","family":"Kjer","sequence":"first","affiliation":[{"name":"Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, 7100 Vejle, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7622-8402","authenticated-orcid":false,"given":"Mads Hvid","family":"Poulsen","sequence":"additional","affiliation":[{"name":"Department for Urology, Esbjerg and Grindsted Hospital, University Hospital of Southern Denmark, 6700 Esbjerg, Denmark"},{"name":"Department of Regional Health Research, University of Southern Denmark, 5230 Odense, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanne","family":"Kj\u00e6r-Frifeldt","sequence":"additional","affiliation":[{"name":"Department of Pathology, Vejle Hospital, University Hospital of Southern Denmark, 7100 Vejle, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0637-9560","authenticated-orcid":false,"given":"Marianne Ingerslev","family":"Holt","sequence":"additional","affiliation":[{"name":"Department of Clinical Genetics, Vejle Hospital, University Hospital of Southern Denmark, 7100 Vejle, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mie Holm","family":"Vilstrup","sequence":"additional","affiliation":[{"name":"Department of Radiology and Nuclear Medicine, Esbjerg and Grindsted Hospital, University Hospital of Southern Denmark, 6700 Esbjerg, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8895-6394","authenticated-orcid":false,"given":"Ahmed H.","family":"Zedan","sequence":"additional","affiliation":[{"name":"Department of Oncology, Vejle Hospital, University Hospital of Southern Denmark, 7100 Vejle, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1111\/j.1464-410X.2011.10523.x","article-title":"Survival of Patients with Small Cell Carcinoma of the Prostate during 1973\u20132003: A Population-Based Study","volume":"109","author":"Deorah","year":"2012","journal-title":"BJU Int."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1038\/nrurol.2014.21","article-title":"Small Cell Carcinoma of the Prostate","volume":"11","author":"Nadal","year":"2014","journal-title":"Nat. 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