To assess chromogranin A (CGA) and neuron-specific enolase (NSE) levels and changes
in these at different stages of prostatic adenocarcinoma (PCA).Overall, 1095 serum
samples from 395 patients, divided into three treatment groups, were analysed; the
radical prostatectomy (RP) cohort (n = 157) included patients with clinically localized
PCA, while the docetaxel (DOC) and the abiraterone (ABI)/enzalutamide (ENZA) cohorts
included 95 and 143 patients, respectively, with metastatic castration-resistant prostate
cancer. CGA, NSE and total PSA levels were measured using the KRYPTOR method.Baseline
CGA and NSE levels were higher in castration-resistant (DOC and ABI/ENZA cohorts)
than in hormone-naïve, clinically localized PCA (P < 0.001). High baseline CGA levels
were independently associated with poor overall survival in both the DOC and the ABI/ENZA
cohorts, with a stronger association in the ABI/ENZA cohort. In the ABI/ENZA cohort,
a > 50% CGA increase at 3 months was associated with poor survival, especially in
patients with high baseline CGA levels.The two- to threefold higher neuroendocrine
marker levels in castration-resistant compared to hormone-naïve PCA support the presence
of neuroendocrine transdifferentiation under androgen deprivation therapy. Our results
showed patients with high baseline CGA levels who experienced a further CGA increase
during ABI and ENZA treatment had the poorest prognosis. Serum CGA levels could help
in tailoring and monitoring therapy in advanced PCA.
