Cells (Aug 2024)

Impact of Neuroendocrine Differentiation (NED) on Enzalutamide and Abiraterone Efficacy in Metastatic Castration-Resistant Prostate Cancer (mCRPC): A Retrospective Analysis

  • Giovanni Farinea,
  • Mariangela Calabrese,
  • Federica Carfì,
  • Isabella Saporita,
  • Stefano Poletto,
  • Marco Donatello Delcuratolo,
  • Fabio Turco,
  • Marco Audisio,
  • Francesco Rosario Di Stefano,
  • Marcello Tucci,
  • Consuelo Buttigliero

DOI
https://doi.org/10.3390/cells13161396
Journal volume & issue
Vol. 13, no. 16
p. 1396

Abstract

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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. Methods: 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. Results: 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] p p p p Conclusions: 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.

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