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Publication year
2023Source
JCO Precision Oncology, 7, (2023), pp. e2300156, article e2300156ISSN
Publication type
Article / Letter to editor
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Organization
Medical Oncology
Journal title
JCO Precision Oncology
Volume
vol. 7
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p. e2300156
Subject
Radboudumc 15: Urological cancers Medical Oncology; Medical Oncology - Radboud University Medical CenterAbstract
PURPOSE: Reliable biomarkers for response monitoring during radium-223 treatment in patients with metastatic castration-resistant prostate cancer (mCRPC) are lacking. Circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA), obtained from liquid biopsies, are shown to have prognostic value in mCRPC. The aim of this study was to determine the value of CTCs and ctDNA for response evaluation of radium-223. METHODS: In this prospective multicenter study, longitudinal blood draws and imaging were performed in 28 patients with mCRPC and predominantly bone disease, who were treated with radium-223. CTCs were counted (CELLSEARCH CTC test), while fraction of ctDNA was estimated by measuring aneuploidy of cell-free DNA (cfDNA; modified Fast Aneuploidy Screening Test-Sequencing System). CTC counts and aneuploidy score (AS) were categorized as low (<5) and high (≥5). Primary and secondary clinical end points were failure-free survival (FFS), and overall survival (OS) and development of extraosseous metastases, respectively. Additionally, CTC count and AS were related to alkaline phosphatase (ALP) and total tumor volume in bone (TTV(bone)) on positron emission tomography-computed tomography with (68)gallium prostate-specific membrane antigen. RESULTS: FFS was longer in patients with a low CTC count or AS either at baseline or after 12 weeks, whereas for OS, only a significant association with CTC count was observed. Liquid biopsy results correlated well with ALP and TTV(bone) at baseline, but not with change in both parameters after three cycles of radium-223. AS and CTC count were significantly correlated. CONCLUSION: CTC count and AS of cfDNA at baseline and during treatment predict clinical response to radium-223 in patients with mCRPC, warranting future evaluation of their value in treatment guidance.
This item appears in the following Collection(s)
- Academic publications [246860]
- Electronic publications [134292]
- Faculty of Medical Sciences [93474]
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