Cargando…
Could Circulating Tumor Cells and ARV7 Detection Improve Clinical Decisions in Metastatic Castration-Resistant Prostate Cancer? The Istituto Nazionale dei Tumori (INT) Experience
Enzalutamide and abiraterone have been shown to improve progression-free survival (PFS) and overall survival (OS) in metastatic castration-resistant prostate cancer (mCRPC) patients. Moreover, some patients may not benefit from the inhibition of androgen receptor (AR) activity or, alternatively, may...
Autores principales: | , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6678845/ https://www.ncbi.nlm.nih.gov/pubmed/31337040 http://dx.doi.org/10.3390/cancers11070980 |
_version_ | 1783441198732541952 |
---|---|
author | Sepe, Pierangela Verzoni, Elena Miodini, Patrizia Claps, Melanie Ratta, Raffaele Martinetti, Antonia Mennitto, Roberta Sottotetti, Elisa Procopio, Giuseppe Cappelletti, Vera Daidone, Maria Grazia |
author_facet | Sepe, Pierangela Verzoni, Elena Miodini, Patrizia Claps, Melanie Ratta, Raffaele Martinetti, Antonia Mennitto, Roberta Sottotetti, Elisa Procopio, Giuseppe Cappelletti, Vera Daidone, Maria Grazia |
author_sort | Sepe, Pierangela |
collection | PubMed |
description | Enzalutamide and abiraterone have been shown to improve progression-free survival (PFS) and overall survival (OS) in metastatic castration-resistant prostate cancer (mCRPC) patients. Moreover, some patients may not benefit from the inhibition of androgen receptor (AR) activity or, alternatively, may develop secondary resistance. Detection in patients’ circulating tumor cells (CTCs) of ARV7, a splicing variant of AR lacking the ligand-binding domain, showed a link with treatment failure. Independent confirmation of the predictive role of CTC status combined with ARV7 detection is, therefore, a priority for extending personalized biomarker-driven treatments to all patients. In this prospective observational study, CTC status and the expression of AR and ARV7 were measured in 37 mCRPC patients, before starting treatment with enzalutamide or abiraterone, by employing commercially available kits. CTC status was positive in 21/37 patients: 46% and 24% of CTC-positive patients were defined as AR- and ARV7-positive, respectively. Kaplan–Meier estimates showed that positivity for each variable was significantly associated with poorer radiological PFS, PSA-PFS, and OS. All considered treatment outcomes worsened when going from CTC-negative to CTC-positive/ARV7-negative to CTC-positive/ARV7-positive patients, both in the global case series and in patients stratified into three groups based on basal PSA levels. Presently, technical approaches appear to be mature for introducing CTC/ARV7 tests in clinical practice. |
format | Online Article Text |
id | pubmed-6678845 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-66788452019-08-19 Could Circulating Tumor Cells and ARV7 Detection Improve Clinical Decisions in Metastatic Castration-Resistant Prostate Cancer? The Istituto Nazionale dei Tumori (INT) Experience Sepe, Pierangela Verzoni, Elena Miodini, Patrizia Claps, Melanie Ratta, Raffaele Martinetti, Antonia Mennitto, Roberta Sottotetti, Elisa Procopio, Giuseppe Cappelletti, Vera Daidone, Maria Grazia Cancers (Basel) Article Enzalutamide and abiraterone have been shown to improve progression-free survival (PFS) and overall survival (OS) in metastatic castration-resistant prostate cancer (mCRPC) patients. Moreover, some patients may not benefit from the inhibition of androgen receptor (AR) activity or, alternatively, may develop secondary resistance. Detection in patients’ circulating tumor cells (CTCs) of ARV7, a splicing variant of AR lacking the ligand-binding domain, showed a link with treatment failure. Independent confirmation of the predictive role of CTC status combined with ARV7 detection is, therefore, a priority for extending personalized biomarker-driven treatments to all patients. In this prospective observational study, CTC status and the expression of AR and ARV7 were measured in 37 mCRPC patients, before starting treatment with enzalutamide or abiraterone, by employing commercially available kits. CTC status was positive in 21/37 patients: 46% and 24% of CTC-positive patients were defined as AR- and ARV7-positive, respectively. Kaplan–Meier estimates showed that positivity for each variable was significantly associated with poorer radiological PFS, PSA-PFS, and OS. All considered treatment outcomes worsened when going from CTC-negative to CTC-positive/ARV7-negative to CTC-positive/ARV7-positive patients, both in the global case series and in patients stratified into three groups based on basal PSA levels. Presently, technical approaches appear to be mature for introducing CTC/ARV7 tests in clinical practice. MDPI 2019-07-13 /pmc/articles/PMC6678845/ /pubmed/31337040 http://dx.doi.org/10.3390/cancers11070980 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Sepe, Pierangela Verzoni, Elena Miodini, Patrizia Claps, Melanie Ratta, Raffaele Martinetti, Antonia Mennitto, Roberta Sottotetti, Elisa Procopio, Giuseppe Cappelletti, Vera Daidone, Maria Grazia Could Circulating Tumor Cells and ARV7 Detection Improve Clinical Decisions in Metastatic Castration-Resistant Prostate Cancer? The Istituto Nazionale dei Tumori (INT) Experience |
title | Could Circulating Tumor Cells and ARV7 Detection Improve Clinical Decisions in Metastatic Castration-Resistant Prostate Cancer? The Istituto Nazionale dei Tumori (INT) Experience |
title_full | Could Circulating Tumor Cells and ARV7 Detection Improve Clinical Decisions in Metastatic Castration-Resistant Prostate Cancer? The Istituto Nazionale dei Tumori (INT) Experience |
title_fullStr | Could Circulating Tumor Cells and ARV7 Detection Improve Clinical Decisions in Metastatic Castration-Resistant Prostate Cancer? The Istituto Nazionale dei Tumori (INT) Experience |
title_full_unstemmed | Could Circulating Tumor Cells and ARV7 Detection Improve Clinical Decisions in Metastatic Castration-Resistant Prostate Cancer? The Istituto Nazionale dei Tumori (INT) Experience |
title_short | Could Circulating Tumor Cells and ARV7 Detection Improve Clinical Decisions in Metastatic Castration-Resistant Prostate Cancer? The Istituto Nazionale dei Tumori (INT) Experience |
title_sort | could circulating tumor cells and arv7 detection improve clinical decisions in metastatic castration-resistant prostate cancer? the istituto nazionale dei tumori (int) experience |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6678845/ https://www.ncbi.nlm.nih.gov/pubmed/31337040 http://dx.doi.org/10.3390/cancers11070980 |
work_keys_str_mv | AT sepepierangela couldcirculatingtumorcellsandarv7detectionimproveclinicaldecisionsinmetastaticcastrationresistantprostatecancertheistitutonazionaledeitumoriintexperience AT verzonielena couldcirculatingtumorcellsandarv7detectionimproveclinicaldecisionsinmetastaticcastrationresistantprostatecancertheistitutonazionaledeitumoriintexperience AT miodinipatrizia couldcirculatingtumorcellsandarv7detectionimproveclinicaldecisionsinmetastaticcastrationresistantprostatecancertheistitutonazionaledeitumoriintexperience AT clapsmelanie couldcirculatingtumorcellsandarv7detectionimproveclinicaldecisionsinmetastaticcastrationresistantprostatecancertheistitutonazionaledeitumoriintexperience AT rattaraffaele couldcirculatingtumorcellsandarv7detectionimproveclinicaldecisionsinmetastaticcastrationresistantprostatecancertheistitutonazionaledeitumoriintexperience AT martinettiantonia couldcirculatingtumorcellsandarv7detectionimproveclinicaldecisionsinmetastaticcastrationresistantprostatecancertheistitutonazionaledeitumoriintexperience AT mennittoroberta couldcirculatingtumorcellsandarv7detectionimproveclinicaldecisionsinmetastaticcastrationresistantprostatecancertheistitutonazionaledeitumoriintexperience AT sottotettielisa couldcirculatingtumorcellsandarv7detectionimproveclinicaldecisionsinmetastaticcastrationresistantprostatecancertheistitutonazionaledeitumoriintexperience AT procopiogiuseppe couldcirculatingtumorcellsandarv7detectionimproveclinicaldecisionsinmetastaticcastrationresistantprostatecancertheistitutonazionaledeitumoriintexperience AT cappellettivera couldcirculatingtumorcellsandarv7detectionimproveclinicaldecisionsinmetastaticcastrationresistantprostatecancertheistitutonazionaledeitumoriintexperience AT daidonemariagrazia couldcirculatingtumorcellsandarv7detectionimproveclinicaldecisionsinmetastaticcastrationresistantprostatecancertheistitutonazionaledeitumoriintexperience |