The use of circulating tumor cells in guiding treatment decisions for patients with metastatic castration-resistant prostate cancer. (May 2016)

• Record Type: Journal Article
• Authors: Onstenk, Wendy; de Klaver, Willemijn; de Wit, Ronald; Lolkema, Martijn; Foekens, John; Sleijfer, Stefan
• Is Part Of: Cancer treatment reviews. Volume 46(2016)
• Page Start: 42
• Page End: 50
• Publication Date: 2016-05
• Subjects: aCGH array comparative genomic hybridization -- ADT androgen deprivation therapy -- AR androgen receptor -- AR-V7 androgen receptor splice variant 7 -- CI confidence interval -- CK cytokeratin -- CT computed tomography -- CTC circulating tumor cell -- EGFR epidermal growth factor receptor -- EpCAM epithelial cell adhesion molecule -- FDA Food and Drug-administration -- FISH Fluorescence in situ Hybridization -- HER2 human epidermal growth factor receptor 2 -- HR hazard ratio -- IF immunofluorescence -- IM immunomagnetical -- LDH lactate dehydrogenase -- mCRPC metastatic castration-resistant prostate cancer -- mRNA messenger ribonucleic acid -- OS overall survival -- PCR polymerase chain reaction -- PCWG2 Prostate Cancer Working Group 2 -- PD progressive disease -- PFS progression-free survival -- PSA prostate specific antigen -- PSMA prostate specific membrane antigen -- RECIST response evaluation criteria in solid tumors -- RR response rate -- RT-qPCR reverse transcription quantitative polymerase chain reaction -- sd standard deviation; Circulating tumor cells -- Metastatic castration-resistant prostate cancer -- Prognostic -- Predictive -- Characterization -- CellSearch; Cancer -- Periodicals; Cancer -- Treatment -- Periodicals; Neoplasms -- therapy -- Periodicals; Cancer -- Périodiques; Cancer -- Traitement -- Périodiques; Cancer -- Treatment; Electronic journals; Periodicals; 616.99406
• DOI: 10.1016/j.ctrv.2016.04.001
• Languages: English
• ISSNs: 0305-7372

Abstract

Highlights: Tools to guide treatment sequencing for mCRPC patients are urgently needed. The CellSearch CTC count from peripheral blood is a strong prognostic factor for OS. The CTC count outperforms PSA and radiography in early treatment response evaluation. The presence of AR-V7 in CTCs predicts resistance to anti-AR treatments. Further CTC characterization will likely help to select the best treatment up-front. Abstract: The therapeutic landscape of metastatic castration-resistant prostate cancer (mCRPC) has drastically changed over the past decade with the advent of several new anti-tumor agents. Oncologists increasingly face dilemmas concerning the best treatment sequence for individual patients since most of the novel compounds have been investigated and subsequently positioned either pre- or post-docetaxel. A currently unmet need exists for biomarkers able to guide treatment decisions and to capture treatment resistance at an early stage thereby allowing for an early change to an alternative strategy. Circulating tumor cells (CTCs) have in this context intensively been investigated over the last years. The CTC count, as determined by the CellSearch System (Janssen Diagnostics LLC, Raritan, NJ), is a strong, independent prognostic factor for overall survival in patients with mCRPC at various time points during treatment and, as an early response marker, outperforms traditional response evaluations using serum prostate specific antigen (PSA) levels, scintigraphy as well as radiography. The focus of research is now shifting toward the predictive value of CTCs and the use of the characterization of CTCs to guide the selection of treatments with the highest chance of success for individual patients. Recently, the presence of the androgen receptor splice variant 7 ( AR-V7 ) has been shown to be a promising predictive factor. In this review, we have explored the clinical value of the enumeration and characterization of CTCs for the treatment of mCRPC and have put the results obtained from recent studies investigating the prognostic and predictive value of CTCs into clinical perspective.