Predicting Prostate Cancer Resistance to Hormonal Treatment by Measuring Serum Concentrations of Chromogranin A
Continued progression of prostate cancer during endocrine therapy is a major clinical problem. Hormonal treatment resistance and development of metastasis during the treatment have been linked to neuroendocrine cell differentiation within the prostate tumor. Prostatic neuroendocrine cells lack androgen receptors and are therefore unaffected by ablation therapy; they not only proliferate after this therapy, but also have a tendency to become malignant. Pure neuroendocrine malignancies of the prostate can also be found in small cell carcinoma and carcinoid-like tumors, both of which, while rare, are highly aggressive and malignant and should be treated with chemotherapy. These neuroendocrine cells contain one or more neuropeptides, including chromogranin A (CgA). Serum CgA in high concentrations (>100 ng/mL) has been correlated with neuroendocrine differentiation.
Total prostate-specific antigen (tPSA) assays have long been used as a way to detect the advancement of prostate cancer. As resistance to hormone therapy builds and neuro-endocrine differentiation occurs, tPSA levels increase. However, the increase is often detected after the resistance has developed and metastasis has occurred. It has been shown that CgA levels increase much earlier than those of tPSA in response to neuroendocrine differentiation. This invention is a means to monitor serum CgA routinely and periodically during treatment of prostate cancer, especially during hormone therapy, in addition to the tPSA assay, resulting in earlier detection of resistance and more effective treatment
Prostate cancer is the most commonly diagnosed non-skin cancer in the United States. One in six American men will develop prostate cancer in the course of his lifetime. This method for the prediction of prostate cancer patients� resistance to hormonal treatment by measuring serum concentrations of the neuropeptide chromogranin A is very valuable tool.
Stage of Development
Patent 6,238,877 has been issued from the United States Patent and Trademark Office.
This technology is available for licensing under non-exclusive terms.
Wu JT, Astill ME, Liu GH, Stephenson RA. (1998) Serum chromogranin A: early detection of hormonal resistance in prostate cancer patients. J Clin Lab Anal. 12:20-5.
Mark Astill, James Wu
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