OBJECTIVE: Circulating tumor cells (CTCs) have known prognostic implications in metastatic castration-resistant prostate cancer, but little is known regarding its utility in biochemical recurrence (BR) of prostate cancer.
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The primary objectives were to determine whether CTCs are measurable in patients with BR and whether it can reliably predict prostate-specific antigen (PSA) increase and PSA doubling times (PSADTs).
METHODS: BR was identified in patients after prostatectomy or radiation or both, with a PSA increase of ≥ 0.2 for prior prostatectomy or > 2 mg/dL increase for post-nadir in prior radiotherapy. CTCs were enumerated at baseline at the time of study entry using the CellSearch (Janssen Diagnostics, Raritan, NJ) test.
RESULTS: The median age for all 36 patients accrued was 69.5 years (range, 51-91) with a median PSA of 1.65 ng/mL (range, 0.2-65.8). Gleason scores ranged from 5 to 9 (median, 7). The majority had prostatectomy (n = 25), external beam radiotherapy (n = 9), CyberKnife (Accuray, Sunnyvale, CA) (n = 1), and combined radiohormonal therapy (n = 1). PSADT ranged from 0.35 to 55 months, with a median of 7.43 months. The incidence of positive CTCs was 8.3% (3 patients), of whom 2 had biopsy-proven bony lesions on presenting with equivocal scans and PSADTs of 2.27 and 3.08 months, respectively. The third CTC-positive patient had a PSADT of 4.99 months.
CONCLUSIONS: Obtaining CTCs in unselected patients presenting with BR has a relatively low yield. However, obtaining a positive CTC raises the suspicion of the presence of metastatic disease and may have utility for longitudinal follow-ups of patients with BR.
Aragon-Ching JB, Siegel RS, Frazier H 2nd, Andrawis R, Hendricks F, Phillips M, Jarrett T, Guebre-Xabiher H, Patierno S, Simmens SJ. Are you the author?
Division of Hematology and Oncology, Department of Medicine, The George Washington University Medical Center, Washington, DC; Department of Urology, The George Washington University Medical Center, Washington, DC; Department of Medicine, Duke Cancer Institute, Durham, NC; Department of Epidemiology and Biostatistics, The George Washington University, Washington, DC.
Reference: Clin Genitourin Cancer. 2015 Apr 18. pii: S1558-7673(15)00075-0.