Berruti A et al. (2007) Chromogranin A expression in patients with hormone naive prostate cancer predicts the development of hormone refractory disease. J Urol 178: 838–843

Chromogranin A, a marker of neuroendocrine differentiation, has previously been identified as an indicator of poor prognosis in patients with hormone-refractory prostate cancer. Researchers in Italy have now found chromogranin A to be an independent predictor for the development of hormone-refractory disease in newly diagnosed hormone-naive prostate cancer patients.

Berruti et al. measured chromogranin A in tumor biopsy and serum samples from 211 patients with newly diagnosed prostate cancer who received androgen deprivation therapy early (within 1 or 2 months) after diagnosis. Patients whose biopsy samples had <30% chromogranin-reactive cells had a hazard ratio (HR) of 2.0 for development of hormone-refractory disease, and 1.7 for shorter survival; in patients with ≥30% chromogranin-positive cells, the HRs were 6.0 and 3.9, respectively. Chromogranin A maintained its predictive status both in patients treated with androgen deprivation therapy alone and in patients treated with radiotherapy or radical prostatectomy in combination with androgen deprivation therapy. Excessive plasma chromogranin A was also associated with time to development of hormone-refractory disease (HR 3.0) and reduced overall survival (HR 2.4).

The authors conclude that chromogranin A, in both prostate biopsy samples and in plasma, is an independent predictor of hormone-refractory disease development and of reduced survival in high-risk prostate cancer patients who receive androgen deprivation therapy within a few months of diagnosis.