ASCO GU 2017: Clinical significance of AR mRNA quantification from circulating tumor cells in men with metastatic castrate resistant prostate cancer treated with abiraterone or enzalutamide - Session Highlights

Orlando, Florida USA (UroToday.com) Prostate cancer is an AR driven disease even in the castrate resistant state. Liquid biopsy allows for real time assessment of the AR receptor. It is known that detection of AR V7 splice variant in CTC's confers lack of sensitivity to abiraterone and enzalutamide.



No data is available on the effect of full length AR mRNA (AR-FL) quantification on prostate cancer outcome. In order to examine this effect a trial was designed in order to quantify AR-FL mRNA in CTC's and correlate it with treatment outcomes. The AR-FL mRNA was quantified by qPCR for complementary DNA specific for AR_FL. 202 patients were enrolled prior to abi/enza treatment. The patients were stratified into 3 groups according to the amount of AR-FL mRNA found in their CTC's: negative (no CTC's or no AR-FL mRNA), low (mRNA<median) and="" high="" (mrna="">median). There was strong correlation between AR-FL and AR-v7. Also, an inverse relation was found between AR-FL and 50% decline in PSA. Negative, low and high AR-FL patients had PSA decline in 62%, 54% and 28% respectively. AR-FL status was correlated with PSA and radiographic progression free survival and overall survival. On MVA, AR-FL was significant for predicting PSA PFS and OS. AR-V7 remained independently prognostic for all outcomes in MVA. This trial suggests that AR-FL copy number is prognostic for clinical outcome in abi/enza treated patients. Furthermore, AR-FL quantification could serve as another molecular marker in addition to AR-V7 splice variant.

Presenter: Emmanuel Anatonarakis, MD

Written By: Miki Haifler, MD, M.Sc, Fox Chase Cancer Center

at the 2017 Genitourinary Cancers Symposium - February 16 - 18, 2017 – Orlando, Florida USA