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. 2023 Apr;55(4):883-892.
doi: 10.1007/s11255-023-03481-9. Epub 2023 Jan 29.

Circulating tumor cell quantification during abiraterone plus prednisone therapy may estimate survival in metastatic castration-resistant prostate cancer patients

Tengfei Gu  1 , Jie Li  1 , Ting Chen  1 , Qingfeng Zhu  1 , Jiafeng Ding  2
Affiliations

Circulating tumor cell quantification during abiraterone plus prednisone therapy may estimate survival in metastatic castration-resistant prostate cancer patients

Tengfei Gu et al. Int Urol Nephrol. 2023 Apr.

Abstract

Purpose: Circulating tumor cells (CTCs) predict survival in response to different interventions in metastatic castration-resistant prostate cancer (mCRPC) patients. This study aimed to explore the dynamic change in CTCs during abiraterone plus prednisone therapy and its optimal threshold for prognostication in mCRPC patients.

Methods: CTCs in blood samples from mCRPC patients (N = 98) at baseline and in the 2nd month after abiraterone plus prednisone treatment initiation (M2) were enumerated by using the CellSearch System.

Results: CTCs were detected in 64.8% of mCRPC patients at baseline with a median value (interquartile range) of 2.0 (0.0-4.0). Elevated CTC count was related to visceral metastasis (P = 0.003), high alkaline phosphatase (P = 0.043), and high lactate dehydrogenase (P = 0.007). Baseline CTC ≥ 1 (vs. < 1) was only associated with shortened radiographic progression-free survival (rPFS) (P = 0.043); additionally, baseline CTC ≥ 5 (vs. < 5) was linked with unfavorable rPFS (P = 0.037) and overall survival (OS) (P = 0.021). Following the therapy, CTCs were reduced at M2 (P < 0.001). Notably, CTC ≥ 1 (vs. < 1) (P = 0.002) and CTC ≥ 5 (vs. < 5) (P < 0.001) at M2 were related to shortened rPFS according to the Kaplan‒Meier curves, and they could independently estimate deteriorative rPFS in the multivariate Cox regression (P = 0.043 and P = 0.027, respectively). Similarly, CTC ≥ 1 (vs. < 1) (P = 0.022) and CTC ≥ 5 (vs. < 5) (P = 0.002) at M2 were related to shortened OS, whereas only CTC ≥ 5 (vs. < 5) could independently predict unfavorable OS (P = 0.017).

Conclusion: CTC count ≥ 5 at M2 exhibits excellent prognostic value for abiraterone plus prednisone therapy in mCRPC patients.

Keywords: Abiraterone plus prednisone therapy; Circulating tumor cell; Dynamic change; Metastatic castration-resistant prostate cancer; Survival.

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