For a study, researchers sought to understand that numerous histological reactions can be induced by neoadjuvant intense androgen deprivation therapy (iADT), which are then reflected in the final material from the prostatectomy. Tracking and stratifying patient outcomes depends on the precise identification and quantification of residual tumor volumes. In this work, investigatorspredicted that prostate-specific membrane antigen (PSMA)-specific immunohistochemistry (IHC) would be a sensitive and specific marker for detecting residual prostate tumors after neoadjuvant iADT. They demonstrate that, in contrast to benign glands, prostate cancers treated with 6 months of AR-targeted neoadjuvant therapy retain significant levels of PSMA expression. In a cohort of 35 patients who received iADT plus enzalutamide for 6 months before radical prostatectomy, the objective of the current study was to assess the capability of antibodies against PSMA to detect the residual tumor selectively. In 31 patients, residual cancer was found, and PSMA always responded favorably to the tumor. Approximately 82% of temperate regions showed no reaction to PSMA staining, which was 96% sensitive for tumors. In comparison, in a control cohort of 37 untreated cases, PSMA showed a good response in 72% of temperate regions, resulting in a 28%  specificity. Additionally, PSMA detected tumors with signs of neuroendocrine differentiation and highly dedifferentiated prostate carcinomas. Study groupsuggested using anti-PSMA immunostaining as a standardized marker to detect cancer that had returned after iADT.

Source: auajournals.org/doi/10.1097/JU.0000000000002492