嗜铬粒蛋白A
医学
前列腺癌
内科学
前列腺特异性抗原
泌尿科
肿瘤科
烯醇化酶
胃肠病学
比例危险模型
无进展生存期
癌症
化疗
免疫组织化学
作者
Matthias Heck,Markus Thaler,Sebastian Schmid,Anna-Katharina Seitz,Robert Tauber,Hubert Kübler,Tobias Maurer,Mark Thalgott,Georgios Hatzichristodoulou,Michael Höppner,Roman Nawroth,Peter B. Luppa,Jürgen E. Gschwend,Margitta Retz
出处
期刊:BJUI
[Wiley]
日期:2016-04-27
卷期号:119 (1): 30-37
被引量:41
摘要
Objective To determine the impact of elevated neuroendocrine serum markers on treatment outcome in patients with metastatic castration‐resistant prostate cancer ( mCRPC ) undergoing treatment with abiraterone in a post‐chemotherapy setting. Patients and Method Chromogranin A ( CG a) and neurone‐specific enolase ( NSE ) were determined in serum drawn before treatment with abiraterone from 45 patients with mCRPC . Outcome measures were overall survival ( OS ), prostate‐specific antigen ( PSA ) response defined by a PSA level decline of ≥50%, PSA progression‐free survival ( PSA ‐ PFS ), and clinical or radiographic PFS . Results The CG a and NSE serum levels did not correlate ( P = 0.6). Patients were stratified in to low‐ (nine patients), intermediate‐ (18) or high‐risk (18) groups according to elevation of none, one, or both neuroendocrine markers, respectively. The risk groups correlated with decreasing median OS (median OS not reached vs 15.3 vs 6.6 months; P < 0.001), decreasing median clinical or radiographic PFS (8.3 vs 4.4 vs 2.7 months; P = 0.001) and decreasing median PSA ‐ PFS (12.0 vs 3.2 vs 2.7 months; P = 0.012). In multivariate Cox regression analysis the combination of CG a and NSE (≥1 marker positive vs both markers negative) remained significant predictors of OS , clinical or radiographic PFS , and PSA ‐ PFS . We did not observe a correlation with PSA response (63% vs 35% vs 31%; P = 0.2). Conclusion Chromogranin A and NSE did not predict PSA response in patients with mCRPC treated with abiraterone. However, we observed a correlation with shorter PSA ‐ PFS , clinical or radiographic PFS , and OS . This might be due to an elevated risk of developing resistance under abiraterone treatment related to neuroendocrine differentiation.
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