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Journal of Cancer Research and Clinical Oncology

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13-03-2023 | Prostate Cancer | Research

Neuroendocrine differentiation predicts the therapeutic efficacy of abiraterone and docetaxel as first-line therapy in metastatic castration-resistant prostate cancer

Authors: Nanwei Xu, Jinge Zhao, Fengnian Zhao, Haoyang Liu, Wenlian Yin, Sha Zhu, Ling Nie, Guangxi Sun, Linmao Zheng, Zhenhua Liu, Diming Cai, Junru Chen, Jindong Dai, Yuchao Ni, Zhipeng Wang, Xingming Zhang, Jiayu Liang, Yuntian Chen, Xu Hu, Xiuyi Pan, Xiaoxue Yin, Xudong Zhu, Yaowen Zhang, Zilin Wang, Yuhao Zeng, Minghao Wang, Pengfei Shen, Ni Chen, Hao Zeng

Published in: Journal of Cancer Research and Clinical Oncology | Issue 10/2023

Abstract

Purpose

We aim to explore the predictive value of neuroendocrine differentiation (NED) in patients with metastatic castration-resistant prostate cancer (mCRPC) receiving abiraterone or docetaxel as first-line therapy.

Methods

We retrospectively analyzed data of 262 mCRPC patients receiving abiraterone or docetaxel as first-line mCRPC treatment. NED was evaluated using prostate biopsy samples at the time of mCRPC by immunohistochemical staining. Kaplan–Meier curves and Cox regression were used to assess the association between NED and treatment outcomes including PSA progression-free survival (PSA-PFS), radiographic progression-free survival (rPFS), and overall survival (OS).

Results

NED was confirmed in 100/262 (38.2%) mCRPC patients, with 76/100 (76.0%) and 24/100 (24.0%) men harboring NED < 10% and NED ≥ 10%, respectively. 203/262 (77.5%) and 59/262 (22.5%) patients received abiraterone and docetaxel, respectively. In abiraterone treatment, NED was associated with a significantly shorter median PSA-PFS (mPSA-PFS, 7.5 vs. 10.3-Mo, P < 0.001), median rPFS (mrPFS, 15.9 vs. 19.5-Mo, P = 0.010), and median OS (mOS, 23.2 vs. 34.3-Mo, P = 0.014)). Likewise, for mCRPC patients receiving docetaxel, the positive detection of NED also predicted shorter mPSA-PFS (3.8 vs. 5.9-Mo, P = 0.052), mrPFS (8.4 vs. 20.4-Mo, P = 0.016) and mOS (13.6 vs. 29.0-Mo, P = 0.033). The adverse prognostic trait of NED is consistent in most subgroups. Additionally, patients’ survival outcomes deteriorated as the NED proportion grew in both therapies. After propensity score matching, NED-positive patients showed comparable prognosis in abiraterone and docetaxel therapy.

Conclusion

For mCRPC patients receiving abiraterone or docetaxel, NED and its proportion were critical predictive factors. NED detection at mCRPC might aid in predicting patients’ outcomes and optimizing treatment decisions.

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Title: Neuroendocrine differentiation predicts the therapeutic efficacy of abiraterone and docetaxel as first-line therapy in metastatic castration-resistant prostate cancer
Authors: Nanwei Xu
Jinge Zhao
Fengnian Zhao
Haoyang Liu
Wenlian Yin
Sha Zhu
Ling Nie
Guangxi Sun
Linmao Zheng
Zhenhua Liu
Diming Cai
Junru Chen
Jindong Dai
Yuchao Ni
Zhipeng Wang
Xingming Zhang
Jiayu Liang
Yuntian Chen
Xu Hu
Xiuyi Pan
Xiaoxue Yin
Xudong Zhu
Yaowen Zhang
Zilin Wang
Yuhao Zeng
Minghao Wang
Pengfei Shen
Ni Chen
Hao Zeng
Publication date: 13-03-2023
Publisher: Springer Berlin Heidelberg
Keywords: Prostate Cancer
Prostate Cancer
Published in: Journal of Cancer Research and Clinical Oncology / Issue 10/2023
Print ISSN: 0171-5216
Electronic ISSN: 1432-1335
DOI: https://doi.org/10.1007/s00432-023-04639-9

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Abstract

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Conclusion

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