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The serum levels of NED markers were measured before the first\u2010line treatment in 88 patients and also before and after DP therapy in 38 patients. We determined their impact on OS, radiographic progression\u2010free survival (rPFS), and PSA\u2010PFS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In men with an elevation of at least one NED marker (<jats:italic>n<\/jats:italic>\u2009=\u200946) before the first\u2010line treatment, those who received AA and then DP had significantly better worse OS (21.7 months [95% CI 21.0\u201022.4] vs 19.9 months (95% CI 15.3\u201024.5); <jats:italic>P<\/jats:italic>\u2009=\u20090.023. In a multivariate Cox regression analysis, treatment sequencing selection (selecting DP\u2010AA rather than AA\u2010DP) independently predicted OS (HR 0.4, 95% CI 0.2\u20100.9, <jats:italic>P<\/jats:italic>\u2009=\u20090.035) in patients with an elevation of at least one NED marker. However, in the subgroup without NED marker elevation, there was no significant difference in clinical outcomes between AA\u2010DP and DP\u2010AA groups (all <jats:italic>P<\/jats:italic>\u2009&gt;\u20090.05). In the group with continued NED marker evaluation during DP treatment, patients with higher baseline NED markers and obtaining PSA response to DP were more inclined to experience NED markers decline.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Elevated pretreatment serum NED markers might indicate mCRPC patients would get better clinical outcomes from DP\u2010AA than AA\u2010DP. In contrast, those without NED marker elevation had similar outcomes regardless of which agent was chosen first. mCRPC patients with elevated NED markers and chemotherapy response were more inclined to obtain NED markers decline during DP therapy, which could account for this phenomenon.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pros.23762","type":"journal-article","created":{"date-parts":[[2019,1,7]],"date-time":"2019-01-07T04:07:08Z","timestamp":1546834028000},"page":"567-573","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Neuroendocrine differentiation markers guide treatment sequence selection in metastatic castration\u2010resistant prostate cancer"],"prefix":"10.1002","volume":"79","author":[{"given":"Liancheng","family":"Fan","sequence":"first","affiliation":[{"name":"Department of Urology, Renji Hospital, School of Medicine Shanghai Jiao Tong University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan","family":"Yang","sequence":"additional","affiliation":[{"name":"The Second Military Medical University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chenfei","family":"Chi","sequence":"additional","affiliation":[{"name":"Department of Urology, Renji Hospital, School of Medicine Shanghai Jiao Tong University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaowei","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Ren Ji Hospital Shanghai Jiao Tong University School of Medicine Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Ultrasound in Medicine Shanghai Jiaotong University Affiliated Sixth People's Hospital Shanghai Institute of Ultrasound in Medicine Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yiming","family":"Gong","sequence":"additional","affiliation":[{"name":"Department of Urology, Renji Hospital, School of Medicine Shanghai Jiao Tong University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongying","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Nurse, Ren Ji Hospital Shanghai Jiao Tong University School of Medicine Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiahua","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Urology, Renji Hospital, School of Medicine Shanghai Jiao Tong University Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yinjie","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Urology, Renji Hospital, School of Medicine Shanghai Jiao Tong University Shanghai 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