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Chromogranin A and neurone‐specific enolase serum levels as predictors of treatment outcome in patients with metastatic castration‐resistant prostate cancer undergoing abiraterone therapy
Author(s) -
Heck Matthias M.,
Thaler Markus A.,
Schmid Sebastian C.,
Seitz AnnaKatharina,
Tauber Robert,
Kübler Hubert,
Maurer Tobias,
Thalgott Mark,
Hatzichristodoulou Georgios,
Höppner Michael,
Nawroth Roman,
Luppa Peter B.,
Gschwend Jürgen E.,
Retz Margitta
Publication year - 2017
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/bju.13493
Subject(s) - chromogranin a , medicine , prostate cancer , prostate specific antigen , urology , oncology , enolase , gastroenterology , proportional hazards model , progression free survival , cancer , chemotherapy , immunohistochemistry
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.