Aggressive Prostate Cancer Better Understood

It's a rare but exceptionally aggressive form of prostate cancer. Scientists are beginning to learn more about how euroendocrine prostate cancer (NEPC) behaves and how it might be treated.

Medical researchers have uncovered genetic pathways that play a role in NEPC and they've tested a drug that seems to fight the aggressive prostate cancer in two models.

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Dr. Himisha Beltran of Weill Cornell Cancer Center and her colleagues wanted to learn more about NEPC, which usually appears following hormone therapy used to treat prostate adendocarcinoma - the most common type of  prostate cancer.

The research team looked at the genetic expression patterns in seven NEPC tumors, 30 prostate adenocarcinomas, and 5 benign prostate tissue samples. There were vast differences in the genes expressed in NEPCs and prostate adenocarcinomas.

Of particular interest were two genes found in other cancers - the AURKA and MYCN genes. They found that these genes apparently work together to produce the qualities of NEPC in prostate cancer cells.

Drugs that inhibit these genes - aurora kinase inhibitors - are currently being tested in clinical trials. The researchers tested one of the drugs against NEPC cells grown in the laboratory and implanted in mice tumors.

Lab NEPC cells were sensitive to the drug, which also shrunk tumors in the mouse models. It also reduced the number of genetic markers for neuroendocrine cells. Interestingly, prostate andenocarcinoma cells and mouse tumors didn't respond to this drug.

Dr. Beltran noted that most patients with this rare form of prostate cancer die within a year of diagnosis. He said the next step will be to conduct clinical trial.

Study authors said there is evidence that long-term androgen deprivation therapy (ADT) could encourage the transformation of prostate cancer cells into NEPC. They note that the use of new potent ADT, more cases of NEPC may be seen.

Findings from this research appear in the November, 2011 issue of Cancer Discovery.