Serum chromogranin A in monitoring metastatic prostate cancer patients

In a number of studies the important role of neuroendocrine structures during the development of aggressive prostate cancer has been reported. We have recorded serum Chromogranin A and PSA values (CIS biointernational, France) in responders and nonresponders to both hormone therapy (Mab) and chemohormonal treatment (Estracyt) using (BPH) subjects as controls. In BPH patients (12 subjects) the mean CgA serotest value (+/- SD) was 23.3 + 13.9 ng/ml (range 7.2-55.9). In responders (24) and nonresponders (14) to Mab, respective values were 39.5 + 18.3 (7.6-78.4) and 214.8 + 250.3 (9.9-1084.3), while in responders (19) and nonresponders (12) to Estracyt, the mean CgA level was 47.6 +/- 22.7 (4.4-101.2) and 366.7 +/- 291.4 (82.0-925.7). In all patients osseous metastates were detected. Statistical P-values were > 0.05 in the correlation between both responders to hormonal therapy and Estracyt (P = 0.194) and nonresponders to these two therapies (P = 0.179). All other recorded P-values were < 0.01. In some nonresponders to Estracyt (3/12) the normal total PSA value together with %FPSA well below 20 indicated contribution of anaplastic tumor. Cessation of Estracyt therapy in 4/14 responders caused the sharp elevation of CgA serotest level. Accordingly, Estracyt may control the activity of CgA positive structure(s). In accordance with these preliminary data, we advocate the CgA serotest assessment in candidates for hormonal therapy as well as during follow-up of pharmacological treatment.