Chromogranin A and neurone-specific enolase serum levels as predictors of treatment outcome in patients with metastatic castration-resistant prostate cancer undergoing abiraterone therapy
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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. / Heck, Matthias M; Thaler, Markus A; Schmid, Sebastian C; Seitz, Anna-Katharina; Tauber, Robert; Kübler, Hubert; Maurer, Tobias; Thalgott, Mark; Hatzichristodoulou, Georgios; Höppner, Michael; Nawroth, Roman; Luppa, Peter B; Gschwend, Jürgen E; Retz, Margitta.
in: BJU INT, Jahrgang 119, Nr. 1, 01.2017, S. 30-37.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung
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TY - JOUR
T1 - Chromogranin A and neurone-specific enolase serum levels as predictors of treatment outcome in patients with metastatic castration-resistant prostate cancer undergoing abiraterone therapy
AU - Heck, Matthias M
AU - Thaler, Markus A
AU - Schmid, Sebastian C
AU - Seitz, Anna-Katharina
AU - Tauber, Robert
AU - Kübler, Hubert
AU - Maurer, Tobias
AU - Thalgott, Mark
AU - Hatzichristodoulou, Georgios
AU - Höppner, Michael
AU - Nawroth, Roman
AU - Luppa, Peter B
AU - Gschwend, Jürgen E
AU - Retz, Margitta
N1 - © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.
PY - 2017/1
Y1 - 2017/1
N2 - 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 (CGa) 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 CGa 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 CGa 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.
AB - 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 (CGa) 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 CGa 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 CGa 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.
KW - Aged
KW - Aged, 80 and over
KW - Androstenes
KW - Chromogranin A
KW - Disease-Free Survival
KW - Humans
KW - Male
KW - Middle Aged
KW - Neoplasm Metastasis
KW - Phosphopyruvate Hydratase
KW - Predictive Value of Tests
KW - Prostate-Specific Antigen
KW - Prostatic Neoplasms, Castration-Resistant
KW - Retrospective Studies
KW - Treatment Outcome
KW - Journal Article
U2 - 10.1111/bju.13493
DO - 10.1111/bju.13493
M3 - SCORING: Journal article
C2 - 27037533
VL - 119
SP - 30
EP - 37
JO - BJU INT
JF - BJU INT
SN - 1464-4096
IS - 1
ER -
