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2014 ; 20
(11
): 2846-50
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Aggressive variants of castration-resistant prostate cancer
#MMPMID24727321
Beltran H
; Tomlins S
; Aparicio A
; Arora V
; Rickman D
; Ayala G
; Huang J
; True L
; Gleave ME
; Soule H
; Logothetis C
; Rubin MA
Clin Cancer Res
2014[Jun]; 20
(11
): 2846-50
PMID24727321
show ga
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.