@article {Derlin1602, author = {Thorsten Derlin and Rudolf A. Werner and Marcel Lafos and Christoph Henkenberens and Christoph A.J. von Klot and Jan M. Sommerlath Sohns and Tobias L. Ross and Frank M. Bengel}, title = {Neuroendocrine Differentiation and Response to PSMA-Targeted Radioligand Therapy in Advanced Metastatic Castration-Resistant Prostate Cancer: A Single-Center Retrospective Study}, volume = {61}, number = {11}, pages = {1602--1606}, year = {2020}, doi = {10.2967/jnumed.120.241588}, publisher = {Society of Nuclear Medicine}, abstract = {Neuroendocrine differentiation is associated with treatment failure and poor outcome in metastatic castration-resistant prostate cancer. We investigated the effect of circulating neuroendocrine biomarkers on the efficacy of prostate-specific membrane antigen (PSMA){\textendash}targeted radioligand therapy (RLT). Methods: Neuroendocrine biomarker profiles (progastrin-releasing peptide, neuron-specific enolase, and chromogranin-A) were analyzed in 50 patients commencing 177Lu-PSMA-617 RLT. The primary endpoint was a prostate-specific antigen response in relation to baseline neuroendocrine marker profiles. An additional endpoint was progression-free survival. Tumor uptake on posttherapeutic scans, a known predictive marker for response, was used as a control variable. Results: Neuroendocrine biomarker profiles were abnormal in most patients. Neuroendocrine biomarker levels did not predict treatment failure or early progression (P >= 0.13). By contrast, intense PSMA-ligand uptake in metastases predicted both treatment response (P = 0.0030) and reduced risk of early progression (P = 0.0111). Conclusion: Neuroendocrine marker profiles do not predict an adverse outcome from RLT. By contrast, high ligand uptake was confirmed to be crucial for achieving a tumor response.}, issn = {0161-5505}, URL = {https://jnm.snmjournals.org/content/61/11/1602}, eprint = {https://jnm.snmjournals.org/content/61/11/1602.full.pdf}, journal = {Journal of Nuclear Medicine} }