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Clinical Utility of Circulating Tumor Cells in Advanced Prostate Cancer

  • Genitourinary Cancers (DP Petrylak and JW Kim, Section Editors)
  • Published:
Current Oncology Reports Aims and scope Submit manuscript

Abstract

Men with metastatic castration-resistant prostate cancer (mCRPC) frequently have circulating tumor cells (CTCs) that are detectable in their peripheral blood. The CellSearch® method of enumerating CTCs is presently the only FDA-cleared CTC test available clinically for men with mCRPC and has been shown to have prognostic significance in this setting, both before and during systemic therapy. Clinical utility, reflecting the ability of this test to favorably change outcomes, is a more controversial and higher bar. The CellSearch® CTC assay can provide updated prognostic and potentially surrogate information in specific clinical scenarios and in clinical trials, but formal randomized trials of clinical utility remain an unmet clinical need. Recent data suggest that CTCs may harbor genetic information (such as the androgen receptor splice variant 7, AR-V7) relevant to changing clinical management and predicting treatment sensitivity or resistance to cancer therapies such as enzalutamide, abiraterone, and taxane chemotherapies. Further molecular characterization of CTCs, cell-free DNA, or RNA can also provide additional information that may have clinical utility. Thus, CTC research is moving toward predictive medicine, based on the biologic characterization and improvements in clinical outcomes associated with heterogeneous cell types both within and between patients.

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Authors and Affiliations

  1. Division of Medical Oncology, Department of Medicine, Duke Cancer Institute, Duke University Medical Center DUMC 103861, Durham, NC, 27710, USA

    Tian Zhang & Andrew J. Armstrong

  2. Division of Urology, Department of Surgery, Duke Cancer Institute, Duke University Medical Center DUMC 103861, Durham, NC, 27710, USA

    Andrew J. Armstrong

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  1. Tian Zhang
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Corresponding author

Correspondence to Andrew J. Armstrong.

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Conflict of Interest

Tian Zhang has received research support through a grant from Janssen, has received compensation from Bayer for service as a consultant and on an advisory board(s), and has a patent for the detection of circulating tumor cells by novel method pending.

Andrew J. Armstrong has received research support through grants from Janssen, Medivation/Astellas, Bayer, Sanofi, Dendreon, Novartis, Pfizer, Kanglaite, Bristol-Myers Squibb, and ImClone; has received compensation from Janssen, Medivation/Astellas, and Bayer for service as a consultant and from Sanofi and Dendreon for service as both a consultant and speaker; and has a patent for the detection of circulating tumor cells by novel method pending.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Genitourinary Cancers

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Zhang, T., Armstrong, A.J. Clinical Utility of Circulating Tumor Cells in Advanced Prostate Cancer. Curr Oncol Rep 18, 3 (2016). https://doi.org/10.1007/s11912-015-0490-9

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  • DOI: https://doi.org/10.1007/s11912-015-0490-9

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