Aggressive variants of castration-resistant prostate cancer

Himisha Beltran, Scott Tomlins, Ana Aparicio, Vivek Arora, David Rickman, Gustavo Ayala, Jiaoti Huang, Lawrence True, Martin E. Gleave, Howard Soule, Christopher Logothetis, Mark A. Rubin

Research output: Contribution to journalReview articlepeer-review

248 Scopus citations

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.

Original languageEnglish
Pages (from-to)2846-2850
Number of pages5
JournalClinical Cancer Research
Volume20
Issue number11
DOIs
StatePublished - Jun 1 2014

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