Medical Oncology Biostatistics and Clinical Trials, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.) - IRCCS, Via Maroncelli 40, 47014 Meldola (FC), Italy.
Endocr Relat Cancer. 2014 May 8;21(3):487-93. doi: 10.1530/ERC-14-0071. Print 2014 Jun.
In this retrospective study, we evaluated the chromogranin A (CgA) baseline value as a predictor of clinical outcome in patients with metastatic castration-resistant prostate cancer (CRPC) treated with abiraterone 1000 mg per day, whose disease progressed after docetaxel chemotherapy. In the 48 evaluable patients, serum CgA level was normal when <120 ng/ml (group A, n=16), within three times the upper normal value (UNV) when between 120 and 360 (group B, n=16), more than three times the UNV when ≥360 ng/ml (group C, n=16). Decline in PSA level ≥50% or more (PSA RR) was observed in 26 of 48 (54%) patients. PSA response rate did not correlate with the CgA groups. CgA levels more than three times the UNV predicted an early radiological progressive disease in eight of 11 cases (73%). The median progression-free survival (PFS) among the CgA groups A, B, and C was 9.2, 9.2, and 4.8 months respectively, P=0.0459. The median overall survival (OS) among the CgA groups was 19.0, 18.8, and 10.8 months respectively, P=0.2092. In the multivariate analysis, PSA RR (nonresponsive vs responsive) and CgA levels (group 3 vs groups 1+2) were predictors of PFS (P=0.0002 and P=0.0047 respectively), whereas PSA RR only was significantly associated with OS (P=0.0024), while CgA levels remained of borderline significance (P=0.0919). A serum CGA level more than three times the UNV predicted PFS and showed a trend vs OS prediction, independently from PSA response, in CRPC patients treated with abiraterone.
在这项回顾性研究中，我们评估了嗜铬粒蛋白 A（CgA）基线值作为接受每日 1000 毫克阿比特龙治疗的转移性去势抵抗性前列腺癌（CRPC）患者临床结局的预测因子，这些患者在接受多西他赛化疗后疾病进展。在 48 例可评估的患者中，血清 CgA 水平正常时<120ng/ml（组 A，n=16），在 120 至 360ng/ml 之间时为三倍正常上限（UNV）以内（组 B，n=16），当≥360ng/ml 时大于三倍 UNV（组 C，n=16）。48 例患者中有 26 例（54%）观察到 PSA 水平下降≥50%（PSA RR）。PSA 反应率与 CgA 组无关。CgA 水平超过三倍 UNV 预测 11 例中的 8 例（73%）早期影像学进展性疾病。CgA 组 A、B 和 C 的中位无进展生存期（PFS）分别为 9.2、9.2 和 4.8 个月，P=0.0459。CgA 组的中位总生存期（OS）分别为 19.0、18.8 和 10.8 个月，P=0.2092。在多变量分析中，PSA RR（无反应与有反应）和 CgA 水平（组 3 与组 1+2）是 PFS 的预测因子（P=0.0002 和 P=0.0047），而 PSA RR 仅与 OS 显著相关（P=0.0024），而 CgA 水平仍具有显著意义（P=0.0919）。血清 CGA 水平超过三倍 UNV 预测 PFS，并与 OS 预测呈趋势相关，在接受阿比特龙治疗的 CRPC 患者中，独立于 PSA 反应。
