Терапевтически индуцированная нейроэндокринная дифференцировка рака предстательной железы.

Abstract

Introduction. The use of selective highly effective antiandrogen drugs in castration-resistant prostate cancer (CRPC) gradually leads to cellular transformation. Objective. To study current concepts of the prevalence of neuroendocrine differentiation (NED) in patients with CRPC, as well as the treatment of this aggressive variant of PCa. Materials and methods. The results of a search in the scientific databases PubMed, in the scientific electronic library eLibrary.ru were analyzed for the following queries - keywords: treatment-induced neuroendocrine prostate cancer, treatment-emergent neuroendocrine prostate cancer, androgen receptor resistance PCa therapy, neuroendocrine prostate cancer treatment. More than 100 scientific papers published in the last 10 years were found, of which 38 were selected for this review based on the objective of the review. Results. In a number of publications, the linear plasticity of prostate adenocarcinoma (PG) in NE tumor was designated as therapy-induced prostate carcinoma (t-NEPCs). The number of observations of NED PCa is growing, including due to the widespread use of powerful aromatase inhibitors. According to a number of studies, NED PCa is observed in 10-20% of patients with metastatic CRPCa, detected after androgen deprivation therapy and therapy with newgeneration antiandrogens, and the condition is characterized by a highly aggressive course and is accompanied by low survival rates. Conclusion. The high prevalence of NED in patients with CRPC, as well as the lack of effective treatment methods, indicate the need to concentrate efforts on studying this clinically relevant, but insufficiently studied condition. The search for new treatment options for NED PCa based on a patho- genetic complex approach is promising and in demand.