Androgen-targeted therapy (ATT) is routinely used on the most common type of prostate cancer, adenocarcinoma, in its early stage. It targets androgens, the male sex hormones that can stimulate tumor growth—but sometimes the hormones become resistant to ATT and are transformed into a more dangerous type, neuroendocrine cancer cells.
Neuroendocrine is a more aggressive form of prostate cancer, spreads easily and is resistant even to chemotherapy, say researchers from Cedars-Sinai Hospital in Los Angeles.
ATT transforms around 25 per cent of adenocarcinoma into neuroendocrine cancer, the researchers reckon. In tests on laboratory mice, the researchers discovered that ATT raises levels of glutamine, an amino acid, in the cells around the cancer cells, creating fuel for the cancer.
They found a similar pattern in people with the two types of prostate cancer; those with neuroendocrine cancer had higher levels of glutamine.
Prostate cancer patients being treated with ATT should have regular blood tests to check their levels of glutamine to monitor whether their cancer is changing to the neuroendocrine type.
(Source: Journal of Clinical Investigation, 2018; 128: 4472-84)