Neuroendocrine Differentiation in Castration-Resistant Prostate Cancer: A Systematic Diagnostic Attempt

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• 作者：Deliu-Victor Matei ; Giuseppe Renne ; Marcelo Pimentel ; Maria Teresa S ; ri ; Laura Zorzino ; Edoardo Botteri ; Concetta De Cicco ; Gennaro Musi ; Antonio Brescia ; Federica Mazzoleni ; Valeria Tringali ; Serena Detti ; Ottavio de Cobelli
• 关键词：Castration-resistant prostate cancer ; Neuroendocrine differentiation ; Octreotide scintigraphy ; Plasma chromogranin A ; Somatostatin analogues ; Tissular chromogranin A
• 刊名：Clinical Genitourinary Cancer
• 出版年：2012
• 出版时间：September, 2012
• 年：2012
• 卷：10
• 期：3
• 页码：164-173
• 全文大小：2446 K

文摘

Background

Assessing the neuroendocrine (NE) pattern in castration-resistant prostate cancer (CRPC) may prove useful in selecting potential responders to target therapies such as somatostatin analogues. The aim of this study was to define a panel of markers or examinations appropriate to characterize NE differentiation (NED).

Methods

Forty-seven patients with CRPC underwent a systematic diagnostic attempt to characterize the NE phenotype using a plasma blood test for chromogranin A (CgA) and immunohistochemical staining of needle biopsy-obtained specimens (CgA, somatostatin receptor 2 [SSTR2], Ki-67, and androgen receptors). In a subgroup of 26 patients, somatostatin receptor scintigraphy using ¹¹¹In-DTPA-d-Phe octreotide (octreotide scintigraphy; Octreoscan, Covidien, Hazelwood, MO) was also performed.

Results

NED was found in 85.1 % of patients (if serum CgA, tissular CgA, and tissular SSTR2 were considered separately: 54 % , 67 % , and 58 % , respectively). Only 15 % of the 26-patient subgroup had an abnormal octreotide scintigraphy result. Although p-CgA and t-CgA were associated with more aggressive disease with a worse prognosis, patients with positive tissular SSTR2 staining had longer overall survival (OS).

Conclusion

This systematic approach to explore the NED in a quite homogeneous group of patients with CRPC seems reproducible and appropriate. Further investigations are required to validate this panel and better characterize potential responders to targeted therapy.