4.6 Article

Comprehensive analysis of serum chromogranin A and neuron-specific enolase levels in localized and castration-resistant prostate cancer

期刊

BJU INTERNATIONAL
卷 127, 期 1, 页码 44-55

出版社

WILEY
DOI: 10.1111/bju.15086

关键词

prostate cancer; chromogranin A; neuron-specific enolase; abiraterone; enzalutamide

资金

  1. National Research, Development and Innovation Office - NKFIH/FK [12443, NVKP_16-1-2016-004]
  2. Janos Bolyai Research Scholarship of the Hungarian Academy of Sciences

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The study assessed chromogranin A (CGA) and neuron-specific enolase (NSE) levels and changes in different stages of prostate cancer. Results showed higher levels of CGA and NSE in castration-resistant patients compared to hormone-naive patients, with high baseline CGA levels associated with poor survival. Serum CGA levels could assist in tailoring and monitoring therapy for advanced prostate cancer.
Objectives To assess chromogranin A (CGA) and neuron-specific enolase (NSE) levels and changes in these at different stages of prostatic adenocarcinoma (PCA). Methods Overall, 1095 serum samples from 395 patients, divided into three treatment groups, were analysed; the radical prostatectomy (RP) cohort (n = 157) included patients with clinically localized PCA, while the docetaxel (DOC) and the abiraterone (ABI)/enzalutamide (ENZA) cohorts included 95 and 143 patients, respectively, with metastatic castration-resistant prostate cancer. CGA, NSE and total PSA levels were measured using the KRYPTOR method. Results Baseline CGA and NSE levels were higher in castration-resistant (DOC and ABI/ENZA cohorts) than in hormone-naive, clinically localized PCA (P < 0.001). High baseline CGA levels were independently associated with poor overall survival in both the DOC and the ABI/ENZA cohorts, with a stronger association in the ABI/ENZA cohort. In the ABI/ENZA cohort, a > 50% CGA increase at 3 months was associated with poor survival, especially in patients with high baseline CGA levels. Conclusions The two- to threefold higher neuroendocrine marker levels in castration-resistant compared to hormone-naive PCA support the presence of neuroendocrine transdifferentiation under androgen deprivation therapy. Our results showed patients with high baseline CGA levels who experienced a further CGA increase during ABI and ENZA treatment had the poorest prognosis. Serum CGA levels could help in tailoring and monitoring therapy in advanced PCA.

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