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Circulating Tumor Cells as a Marker for Progression‐free Survival in Metastatic Castration‐naïve Prostate Cancer
Author(s) -
Josefsson Andreas,
Linder Anna,
Flondell Site Despina,
Canesin Giacomo,
Stiehm Anna,
Anand Aseem,
Bjartell Anders,
Damber JanErik,
Welén Karin
Publication year - 2017
Publication title -
the prostate
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.295
H-Index - 123
eISSN - 1097-0045
pISSN - 0270-4137
DOI - 10.1002/pros.23325
Subject(s) - prostate cancer , medicine , circulating tumor cell , androgen deprivation therapy , oncology , prostate specific antigen , pca3 , prostate , cancer , metastasis
BACKGROUND Analysis of circulating tumor cells (CTC) is a promising prognostic marker in castration‐resistant prostate cancer (CRPC). The aim of this study was to investigate CTC detection and phenotyping as prognostic biomarkers for response to primary androgen deprivation therapy (ADT) of metastatic prostate cancer (PC). METHODS PC patients presenting with a prostate specific antigen (PSA) >80 ng/ml and/or metastatic disease, intended for ADT were enrolled in the study. CTCs were analysed for expression of PSA prostate specific membrane antigen (PSMA) and epidermal growth factor receptor (EGFR) before and three months after ADT and related to progression. RESULTS At inclusion, 46 out of 53 patients (87%) were CTC‐positive with a sensitivity and specificity for distant metastases (M1) of 98% and 75%, respectively. In patients with M1‐disease, EGFR‐detection in CTC was an independent prognostic marker for progression‐free survival, whereas PSA and alkaline phosphatase serum levels, Gleason score, or T‐stage were not. EGFR‐positive patients had significantly shorter time to progression (5 months) compared to EGFR‐negative patients (11 months) ( P < 0.05). CONCLUSIONS In this explorative study, CTCs were detected in 98% of M1 patients and detection of EGFR in CTCs was strongly associated with poor outcome, which indicated that phenotypical analysis of CTC could be a promising prognostic marker of ADT‐response in castration‐naïve metastatic PC patients. Prostate 77:849–858, 2017 . © 2017 Wiley Periodicals, Inc.