Management of Small Cell Neuroendocrine Tumors of the Genitourinary Tract

Molecular diagnostics are rapidly evolving, leading to increased identification of previously 'rare' clinical entities. Variant histology tumors now collectively represent a substantial proportion of clinical practice in GU radiation oncology, though they remain poorly understood and often managed in a one size fits all manner. It is imperative that the radiation oncology professional remain current in the state-of-the-art approaches to diagnosis and management of rare variants of common malignancies like prostate, bladder and kidney cancer. This activity provides learners the opportunity to gain exposure to the latest clinical science in variant tumors like small cell cancer. This exposure is only achieved with active efforts to address the specialized management of unusual presentations that are otherwise encountered sporadically in routine practice.

Small-cell carcinomas (SCCs) of the genitourinary (GU) tract are aggressive malignancies with high metastatic potential that are encountered frequently by GU radiation oncologists. The most common primary sites are the bladder and prostate, but primary SCC of the kidney, ureter and urethra also exist. Radiation therapy plays an important role in the evolving multidisciplinary management of these tumors. This multidisciplinary panel with case-based discussion reviews current management strategies with a focus on the role of radiation therapy.

Topics:

  1. Pathology of GU Small Cell Cancers
    Hikmat Al-Ahmadie, MD
  2. Role of Surgery in the Management of GU Neuroendocrine Carcinoma
    Nima Almassi, MD
  3. Emerging Systemic Therapy and Trials for Small Cell Variants of the GU Tract
    Jean Hoffman-Censits, MD
  4. Radiation Therapy for Small Cell Bladder Cancers
    Vedang Murthy, MD
  5. Radiation for Small Cell Carcinoma of the Prostate
    Emily Steinberger Weg, MD
  6. Case Discussions/Q and A
    Omar Y. Mian, MD, PhD - Moderator
    Full Panel

This activity is available from March 11, 2025, through 11:59 p.m. Eastern time on March 10, 2027. 

The content was originally presented and recorded at the 2024 ASTRO Annual Meeting.

Target Audience

The activity is designed to meet the interests of medical oncologists, radiation oncologists, radiation therapists, radiation biologists and residents.

Learning Objectives

Upon completion of this activity, participants should be able to:

  • Describe the presentation, morphology, diagnostic markers, and imaging characteristics of extrapulmonary small cell cancers of the genitourinary tract, including clinically relevant molecular and genetic characteristics.
  • Understand the emerging evidence-based multimodal strategies including appropriate work up, radiological, pathological features, and systemic therapy leveraging frontline platinum-based chemotherapy and immunotherapy in combination with radiation for locoregional control of small cell neuroendocrine tumors of the GU tract. 
Course summary
Available credit: 
  • 1.25 AMA PRA Category 1 Credit™
    The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education for physicians. ASTRO designates this Enduring material for a maximum of 1.25 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
  • 1.25 Certificate of Attendance
    This activity was designated for 1.25 AMA PRA Category 1 Credit™.
Course opens: 
03/11/2025
Course expires: 
03/10/2027
Cost:
$149.00
Rating: 
0
  • Omar Y. Mian, MD, PhD, is employed by Taussig Cancer Institute, Cleveland Clinic. Dr. Mian receives grant/research funding from Varian and Gilead. Dr. Mian serves as a Panel Member on the NCCN Guidelines Committee.
  • Hikmat Al-Ahmadie, MD, is employed by Memorial Sloan Kettering Cancer Center. Dr. Al-Ahmadie receives compensation/payment from Paige.AI, AstraZeneca and Pfizer.
  • Nima Almassi, MD, is employed by Glickman Urologic and Kidney Institute, Cleveland Clinic Foundation.   
  • Jean Hoffman-Censits, MD, is employed by the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University. Dr. Hoffman-Censits receives grant/research funding and salary support from Seagen, EMD Serono and Roche Genentech. Dr. Hoffman-Censits serves on the NCCN Bladder Cancer Guidelines Committee and the AUA Upper Tract Urothelial Cancer Guidelines Committee. 
  • Vedang Murthy, MD, is employed by Tata Memorial Centre, Homi Bhabha National Institute. Dr. Murthy receives grant/research funding from Varian Medical Systems.
  • Emily Steinberger Weg, MD, is employed by University of Washington – Fred Hutchinson Cancer Center. Dr. Steinberger Weg serves in an uncompensated role as Associate Medical Director of the Fred Hutch Proton Center. 

The person(s) above served as the developer(s) of this activity. Additionally, the ASTRO Education Committee had control over the content of this activity. All relevant financial relationships have been mitigated.

Disclosure link: 
ASTRO Education Committee

The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Available Credit

  • 1.25 AMA PRA Category 1 Credit™
    The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council for Continuing Medical Education for physicians. ASTRO designates this Enduring material for a maximum of 1.25 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
  • 1.25 Certificate of Attendance
    This activity was designated for 1.25 AMA PRA Category 1 Credit™.

Price

Cost:
$149.00
Please login or register to take this course.

Course Fees:
ASTRO members must log in to the ASTRO website to view and receive the member rate.

  • Nonmember: $149
  • Member: $99
  • Member-in-Training: $49
  • Student/Graduate Student/PGY-1 Member: $49
  • Postdoctoral Fellow Member: $49

If you are an ASTRO member from a low or lower-middle income country, as identified by the World Bank, you can receive a 50% discount off your corresponding registration for this activity. Please email [email protected] to inquire about the discount.

Policies:
No refunds, extensions, or substitutions will be made for those participants who, for any reason, have not completed the activity by the expiration date. 

Participants using ASTRO Academy activities to satisfy the requirement of a Continuing Certification (MOC) program should verify the credit number and type and availability dates of any activity before making a purchase. No refunds, extensions, or substitutions will be made for participants who have purchased activities that do not align with their MOC requirement.

The activity and its materials will only be available on the ASTRO website until March 10, 2027, regardless of purchase date. At the expiration of the activity, participants will no longer have access to the activity or its materials. ASTRO reserves the right to remove an activity before its expiration date. 

Required Hardware/software

One of the two latest versions of Google Chrome, Mozilla Firefox, Internet Explorer or Safari.