Clinical Utility of Circulating Tumor Cells in Advanced Prostate Cancer

被引:21
作者
Zhang, Tian [1 ]
Armstrong, Andrew J. [1 ,2 ]
机构
[1] Duke Univ, Med Ctr, Duke Canc Inst, Dept Med,Div Med Oncol, Durham, NC 27710 USA
[2] Duke Univ, Med Ctr, Duke Canc Inst, Dept Surg,Div Urol, Durham, NC 27710 USA
关键词
Circulating tumor cells; Clinical utility; Castration-resistant prostate cancer; Metastatic prostate cancer; AR-V7; Clinical biomarkers; POLYMERASE-CHAIN-REACTION; ABIRATERONE ACETATE; PROGNOSTIC-SIGNIFICANCE; ENZALUTAMIDE MDV3100; ANTITUMOR-ACTIVITY; DOCETAXEL; SURVIVAL; BLOOD; MEN; SURROGATE;
D O I
10.1007/s11912-015-0490-9
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Men with metastatic castration-resistant prostate cancer (mCRPC) frequently have circulating tumor cells (CTCs) that are detectable in their peripheral blood. The CellSearch (R) method of enumerating CTCs is presently the only FDA-cleared CTC test available clinically for men with mCRPC and has been shown to have prognostic significance in this setting, both before and during systemic therapy. Clinical utility, reflecting the ability of this test to favorably change outcomes, is a more controversial and higher bar. The CellSearch (R) CTC assay can provide updated prognostic and potentially surrogate information in specific clinical scenarios and in clinical trials, but formal randomized trials of clinical utility remain an unmet clinical need. Recent data suggest that CTCs may harbor genetic information (such as the androgen receptor splice variant 7, AR-V7) relevant to changing clinical management and predicting treatment sensitivity or resistance to cancer therapies such as enzalutamide, abiraterone, and taxane chemotherapies. Further molecular characterization of CTCs, cell-free DNA, or RNA can also provide additional information that may have clinical utility. Thus, CTC research is moving toward predictive medicine, based on the biologic characterization and improvements in clinical outcomes associated with heterogeneous cell types both within and between patients.
引用
收藏
页码:1 / 8
页数:8
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