Dong B, et al. – Physicians conducted this study to determine the affect of abiraterone Acetate (AA) on neuroendocrine differentiation (NED) in patients with chemotherapy–naive metastatic castration–resistant prostate cancer (mCRPC). They deliberated that AA might not significantly lead to progression of NED of mCRPC in general. Moreover, they observed that there was heterogeneity in changes of NED markers in different mCRPC patients during AA treatment. In addition, serial CgA and NSE evaluation might help clinicians guide clinical treatment of mCRPC patients.

Methods

• Researchers performed an analysis in 115 chemotherapy–naïve mCRPC patients who would be treated with chemotherapy.
• They assessed the serum levels of chromogranin A (CgA), neurone–specific enolase (NSE) in 67 mCRPC patients without AA treatment and 48 patients after the failure of AA treatment, in which these markers were also assessed in 34 patients before and after 6 months of AA treatment.
• They applied comparative t–test to assess the serial changes of serum NED markers during AA treatment and univariate and multivariate analyses were performed to test the influence of AA treatment on NED.

Results

• It was illustrated that serum CgA were NSE were evaluated to be above the upper limit of normal (ULN) in 56 (48.7%) and 29 (25.2%) patients before chemotherapy.
• The data showed that serum CgA level of 14 patients and NSE of 14 patients increased after the failure of AA treatment in 34 patients with serial evaluation.
• No significant difference of NED markers (CgA or NSE variation (P=0.243) was observed between at baseline and after the failure of AA treatment.
• Compared with the CgA elevation group in the first 6 months of AA treatment and baseline supranormal CgA group, the CgA decline group, and baseline normal CgA group has a much longer median PSA PFS (14.34 vs 10.00 months, P<0.001, and 14.23 vs 10.30 months, P=0.02) and rPFS, respectively (18.33 vs 11.37 months, P<0.001, and 17.10 vs 12.07 months, P=0.03).
• This logistic univariate analysis indicated that AA treatment and its duration were not independent factors influencing NED.