Prostate cancers with neuroendocrine differentiation include adenocarcinoma of NEPC, well‐differentiated neuroendocrine tumor, small‐cell neuroendocrine carcinoma, and large‐cell neuroendocrine carcinoma.4De novo NEPC is a rare and highly aggressive malignant cancer.2, 14, 18 Under selection pressure by modern AR‐directed therapy, AR‐positive adenocarcinoma can dedifferentiate into a small‐cell neuroendocrine‐like tumor or treatment‐emergent neuroendocrine PCa (t‐NEPC). This evidence concerns the gene AR and Familial prostate cancer.