title: Somatostatin analogs and disease control in castration-resistant prostate cancer: different biological behavior? Case series and review of the literature.
abstract: OBJECTIVE
  Castration-resistant prostate cancer is a recent biological behavior where disease can elude androgen deprivation therapy (ADT). Several pathways have been described, including neuroendocrine dedifferentiation. Patients with neuroendocrine dedifferentiation show an increase in chromogranin A (CgA) along with a PSA increase. Our aim was to evaluate the response of patients with castration-resistant prostate cancer and high CgA serum levels after treatment with inhibitors of neuroendocrine cells (somatostatin analogs) in combination with ADT.
  
  
  METHODS
  From January 2009 to April 2011, 10 patients with castration-resistant prostate cancer and rising PSA levels along with a CgA increase were evaluated. The therapy was based on somatostatin analogs and LHRH anologs. Total PSA and CgA were measured every 2 months.
  
  
  RESULTS
  In 9 of the 10 patients, a reduction of the values of pre-treatment CgA was detected, while a reduction of PSA was found in 8 patients. No grade 2 or higher toxicity was recorded. Only 3 patients had grade 1 gastrointestinal toxicity. Time to progression was 13 months.
  
  
  CONCLUSIONS
  Therapy with somatostatin analogs could increase the therapeutic window of ADT with a low toxicity profile in a subpopulation of patients with castration-resistant prostate cancer who experience a rise in CgA due to neuroendocrine regulation.
authors: Rolando Maria
authors: RM
authors: D'Angelillo
authors: Carlo
authors: C
authors: Greco
authors: Michele
authors: M
authors: Fiore
authors: Edy
authors: E
authors: Ippolito
authors: Luca
authors: L
authors: Eolo Trodella
authors: Aurelia
authors: A
authors: Iurato
authors: Elisabetta
authors: E
authors: Molfese
authors: Sara
authors: S
authors: Ramella
authors: Lucio
authors: L
authors: Trodella
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000188:drug therapy*; D000368:Aged; D000369:Aged, 80 and over; D000726:Androgen Antagonists / Q000627:therapeutic use; D000736:Androstenes; D000737:Androstenols / Q000008:administration & dosage; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage / Q000627:therapeutic use*; D001549:Benzamides; D014408:Biomarkers, Tumor / Q000097:blood*; D053379:Chromogranin A / Q000097:blood*; D018450:Disease Progression; D004334:Drug Administration Schedule; D007987:Gonadotropin-Releasing Hormone / Q000031:analogs & derivatives; D006801:Humans; D008297:Male; D060787:Neoplasm Grading; D009570:Nitriles; D015282:Octreotide / Q000008:administration & dosage / Q000627:therapeutic use*; D010456:Peptides, Cyclic / Q000008:administration & dosage / Q000627:therapeutic use*; D010669:Phenylthiohydantoin / Q000008:administration & dosage / Q000031:analogs & derivatives; D017430:Prostate-Specific Antigen / Q000097:blood*; D064129:Prostatic Neoplasms, Castration-Resistant / Q000097:blood / Q000188:drug therapy*; D013004:Somatostatin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000726:Androgen Antagonists; D000736:Androstenes; D000737:Androstenols; D018931:Antineoplastic Agents, Hormonal; D001549:Benzamides; D014408:Biomarkers, Tumor; D053379:Chromogranin A; D009570:Nitriles; D010456:Peptides, Cyclic; C060347:lanreotide; D010669:Phenylthiohydantoin; D007987:Gonadotropin-Releasing Hormone; D013004:Somatostatin; C540278:enzalutamide; D017430:Prostate-Specific Antigen; C089740:abiraterone; D015282:Octreotide