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
Affiliations
Giovanni Farinea
Department of Oncology, San Luigi Gonzaga University Hospital, University of Turin, 10043 Orbassano, Italy
Mariangela Calabrese
Department of Oncology, San Luigi Gonzaga University Hospital, University of Turin, 10043 Orbassano, Italy
Federica Carfì
Department of Oncology, San Luigi Gonzaga University Hospital, University of Turin, 10043 Orbassano, Italy
Isabella Saporita
Department of Oncology, San Luigi Gonzaga University Hospital, University of Turin, 10043 Orbassano, Italy
Stefano Poletto
Department of Oncology, San Luigi Gonzaga University Hospital, University of Turin, 10043 Orbassano, Italy
Marco Donatello Delcuratolo
Department of Oncology, San Luigi Gonzaga University Hospital, University of Turin, 10043 Orbassano, Italy
Fabio Turco
Oncology Institute of Southern Switzerland, 6500 Bellinzona, Switzerland
Marco Audisio
Department of Oncology, San Luigi Gonzaga University Hospital, University of Turin, 10043 Orbassano, Italy
Francesco Rosario Di Stefano
Department of Oncology, San Luigi Gonzaga University Hospital, University of Turin, 10043 Orbassano, Italy
Marcello Tucci
Department of Medical Oncology, Cardinal Massaia Hospital, 14100 Asti, Italy
Consuelo Buttigliero
Department of Oncology, San Luigi Gonzaga University Hospital, University of Turin, 10043 Orbassano, Italy
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.
