神经内分泌分化（NED）对转移性去势抵抗性前列腺癌（mCRPC）中恩扎鲁胺和阿比特龙疗效的影响：一项回顾性分析。
Impact of Neuroendocrine Differentiation (NED) on Enzalutamide and Abiraterone Efficacy in Metastatic Castration-Resistant Prostate Cancer (mCRPC): A Retrospective Analysis.
机构信息
Department of Oncology, San Luigi Gonzaga University Hospital, University of Turin, 10043 Orbassano, Italy.
Oncology Institute of Southern Switzerland, 6500 Bellinzona, Switzerland.
出版信息
Cells. 2024 Aug 22;13(16):1396. doi: 10.3390/cells13161396.
Neuroendocrine differentiation (NED) represents a possible androgen receptor pathway inhibitors (ARPI) resistance mechanism in metastatic castration resistance prostate cancer (mCRPC). As mCRPC with NED has been excluded from clinical trials evaluating ARPI efficacy, this study investigates the prognostic impact of NED in mCRPC patients treated with ARPIs. We retrospectively analyzed 327 mCRPC patient data treated with Enzalutamide or Abiraterone in the first and second or successive lines of treatment. NED was assessed using prostate biopsy samples through immunohistochemical staining. NED was confirmed in 32/327 (9.8%) mCRPC patients. In the overall population, mCRPC with NED showed worse PFS (4.38 vs. 11.48 months HR 2.505 [1.71-3.68] < 0.05), disease control rate (DCR), and PSA response. In the first line setting, mCRPC with NED demonstrated worse PFS (8.5 vs. 14.9 months HR 2.13 [1.18-3.88], < 0.05). Similarly, in the second or successive lines, mCRPC with NED showed worse PFS (4.0 vs. 7.5 months HR 2.43 [1.45-4.05] < 0.05), DCR, PSA response and OS (12.53 vs. 18.03 months HR 1.86 [1.12-3.10] < 0.05). The adverse impact of NED on PFS was consistence across all subgroups; we also noted a trend of worse PFS in patients with high vs. low NED. In our study, mCRPC with NED treated with Enzalutamide or Abiraterone showed worse clinical outcomes. NED assessment should be considered to optimize treatment decisions in the mCRPC setting.
神经内分泌分化 (NED) 代表转移性去势抵抗性前列腺癌 (mCRPC) 中雄激素受体途径抑制剂 (ARPI) 耐药的一种可能机制。由于具有 NED 的 mCRPC 已被排除在评估 ARPI 疗效的临床试验之外，因此本研究调查了 NED 在接受 ARPI 治疗的 mCRPC 患者中的预后影响。我们回顾性分析了 327 例接受恩扎卢胺或阿比特龙一线或二线或连续二线治疗的 mCRPC 患者的数据。通过免疫组织化学染色评估前列腺活检样本中的 NED。在 327 例 mCRPC 患者中确认了 32 例（9.8%）具有 NED。在总体人群中，具有 NED 的 mCRPC 患者的 PFS（4.38 与 11.48 个月 HR 2.505[1.71-3.68] <0.05）、疾病控制率（DCR）和 PSA 反应更差。在一线治疗中，具有 NED 的 mCRPC 患者的 PFS 更差（8.5 与 14.9 个月 HR 2.13[1.18-3.88]，<0.05）。同样，在二线或连续二线治疗中，具有 NED 的 mCRPC 患者的 PFS（4.0 与 7.5 个月 HR 2.43[1.45-4.05]，<0.05）、DCR、PSA 反应和 OS（12.53 与 18.03 个月 HR 1.86[1.12-3.10]，<0.05）更差。NED 对 PFS 的不良影响在所有亚组中均一致；我们还注意到，高 NED 与低 NED 患者的 PFS 更差呈趋势。在我们的研究中，接受恩扎卢胺或阿比特龙治疗的具有 NED 的 mCRPC 患者的临床结局更差。在 mCRPC 环境中，应考虑进行 NED 评估以优化治疗决策。
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