Aggressive variants of castration-resistant prostate cancer.

TitleAggressive variants of castration-resistant prostate cancer.
Publication TypeJournal Article
Year of Publication2014
AuthorsBeltran H, Tomlins S, Aparicio A, Arora V, Rickman D, Ayala G, Huang J, True L, Gleave ME, Soule H, Logothetis C, Rubin MA
JournalClin Cancer Res
Volume20
Issue11
Pagination2846-50
Date Published2014 Jun 01
ISSN1557-3265
KeywordsCarcinoma, Neuroendocrine, Humans, Male, Prostatic Neoplasms, Castration-Resistant
Abstract

A subset of patients with advanced castration-resistant prostate cancer may eventually evolve into an androgen receptor (AR)-independent phenotype, with a clinical picture associated with the development of rapidly progressive disease involving visceral sites and hormone refractoriness, often in the setting of a low or modestly rising serum prostate-specific antigen level. Biopsies performed in such patients may vary, ranging from poorly differentiated carcinomas to mixed adenocarcinoma-small cell carcinomas to pure small cell carcinomas. These aggressive tumors often demonstrate low or absent AR protein expression and, in some cases, express markers of neuroendocrine differentiation. Because tumor morphology is not always predicted by clinical behavior, the terms "anaplastic prostate cancer" or "neuroendocrine prostate cancer" have been used descriptively to describe these rapidly growing clinical features. Patients meeting clinical criteria of anaplastic prostate cancer have been shown to predict for poor prognosis, and these patients may be considered for platinum-based chemotherapy treatment regimens. Therefore, understanding variants within the spectrum of advanced prostate cancer has important diagnostic and treatment implications.

DOI10.1158/1078-0432.CCR-13-3309
Alternate JournalClin Cancer Res
PubMed ID24727321
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