RT Journal Article
T1 Decline in Circulating Tumor Cell Count and Treatment Outcome in Advanced Prostate Cancer
A1 Lorente, David
A1 Olmos, David
A1 Mateo, Joaquin
A1 Bianchini, Diletta
A1 Seed, George
A1 Fleisher, Martin
A1 Danila, Daniel C.
A1 Flohr, Penny
A1 Crespo, Mateus
A1 Figueiredo, Ines
A1 Miranda, Susana
A1 Baeten, Kurt
A1 Molina, Arturo
A1 Kheoh, Thian
A1 McCormack, Robert
A1 Terstappen, Leon W. M. M.
A1 Scher, Howard I.
A1 de-Bono, Johann S.
K1 Castration-resistant prostate cancer
K1 Treatment outcome
K1 Response
K1 Circulating tumor cells
K1 Abiraterone
K1 Chemotherapy
K1 Abiraterone acetate
K1 Increased survival
K1 End-points
K1 Chemotherapy
K1 Enzalutamide
K1 Antigen
K1 Trial
K1 Surrogacy
K1 Docetaxel
K1 Biomarker
AB Background: Treatment response biomarkers are urgently needed for castration-resistant prostate cancer (CRPC). Baseline and post-treatment circulating tumor cell (CTC) counts of >= 5 cells/7.5 ml are associated with poor CRPC outcome.Objective: To determine the value of a >= 30% CTC decline as a treatment response indicator.Design, setting, and participants: We identified patients with a baseline CTC count >= 5 cells/7.5 ml and evaluable post-treatment CTC counts in two prospective trials.Intervention: Patients were treated in the COU-AA-301 (abiraterone after chemotherapy) and IMMC-38 (chemotherapy) trials.Outcome measures and statistical analysis: The association between a >= 30% CTC decline after treatment and survival was evaluated using univariable and multivariable Cox regression models at three landmark time points (4, 8, and 12 wk). Model performance was evaluated by calculating the area under the receiver operating characteristic curve (AUC) and c-indices.Results: Overall 486 patients (122 in IMMC-38 and 364 in COU-AA-301) had a CTC count >= 5 cells/7.5 ml at baseline, with 440, 380, and 351 patients evaluable at 4, 8, and 12 wk, respectively. A 30% CTC decline was associated with increased survival at 4 wk (hazard ratio [HR] 0.45, 95% confidence interval [CI] 0.36-0.56; p = 5 cells/7.5 ml are associated with poor CRPC outcome.Objective: To determine the value of a >= 30% CTC decline as a treatment response indicator.Design, setting, and participants: We identified patients with a baseline CTC count >= 5 cells/7.5 ml and evaluable post-treatment CTC counts in two prospective trials.Intervention: Patients were treated in the COU-AA-301 (abiraterone after chemotherapy) and IMMC-38 (chemotherapy) trials.Outcome measures and statistical analysis: The association between a >= 30% CTC decline after treatment and survival was evaluated using univariable and multivariable Cox regression models at three landmark time points (4, 8, and 12 wk). Model performance was evaluated by calculating the area under the receiver operating characteristic curve (AUC) and c-indices.Results: Overall 486 patients (122 in IMMC-38 and 364 in COU-AA-301) had a CTC count >= 5 cells/7.5 ml at baseline, with 440, 380, and 351 patients evaluable at 4, 8, and 12 wk, respectively. A 30% CTC decline was associated with increased survival at 4 wk (hazard ratio [HR] 0.45, 95% confidence interval [CI] 0.36-0.56; p = 30% CTC decline as a treatment response indicator.Design, setting, and participants: We identified patients with a baseline CTC count >= 5 cells/7.5 ml and evaluable post-treatment CTC counts in two prospective trials.Intervention: Patients were treated in the COU-AA-301 (abiraterone after chemotherapy) and IMMC-38 (chemotherapy) trials.Outcome measures and statistical analysis: The association between a >= 30% CTC decline after treatment and survival was evaluated using univariable and multivariable Cox regression models at three landmark time points (4, 8, and 12 wk). Model performance was evaluated by calculating the area under the receiver operating characteristic curve (AUC) and c-indices.Results: Overall 486 patients (122 in IMMC-38 and 364 in COU-AA-301) had a CTC count >= 5 cells/7.5 ml at baseline, with 440, 380, and 351 patients evaluable at 4, 8, and 12 wk, respectively. A 30% CTC decline was associated with increased survival at 4 wk (hazard ratio [HR] 0.45, 95% confidence interval [CI] 0.36-0.56; p = 5 cells/7.5 ml and evaluable post-treatment CTC counts in two prospective trials.Intervention: Patients were treated in the COU-AA-301 (abiraterone after chemotherapy) and IMMC-38 (chemotherapy) trials.Outcome measures and statistical analysis: The association between a >= 30% CTC decline after treatment and survival was evaluated using univariable and multivariable Cox regression models at three landmark time points (4, 8, and 12 wk). Model performance was evaluated by calculating the area under the receiver operating characteristic curve (AUC) and c-indices.Results: Overall 486 patients (122 in IMMC-38 and 364 in COU-AA-301) had a CTC count >= 5 cells/7.5 ml at baseline, with 440, 380, and 351 patients evaluable at 4, 8, and 12 wk, respectively. A 30% CTC decline was associated with increased survival at 4 wk (hazard ratio [HR] 0.45, 95% confidence interval [CI] 0.36-0.56; p = 30% CTC decline after treatment and survival was evaluated using univariable and multivariable Cox regression models at three landmark time points (4, 8, and 12 wk). Model performance was evaluated by calculating the area under the receiver operating characteristic curve (AUC) and c-indices.Results: Overall 486 patients (122 in IMMC-38 and 364 in COU-AA-301) had a CTC count >= 5 cells/7.5 ml at baseline, with 440, 380, and 351 patients evaluable at 4, 8, and 12 wk, respectively. A 30% CTC decline was associated with increased survival at 4 wk (hazard ratio [HR] 0.45, 95% confidence interval [CI] 0.36-0.56; p = 5 cells/7.5 ml at baseline, with 440, 380, and 351 patients evaluable at 4, 8, and 12 wk, respectively. A 30% CTC decline was associated with increased survival at 4 wk (hazard ratio [HR] 0.45, 95% confidence interval [CI] 0.36-0.56; p = 5 cells/7.5 ml and a 30% CTC decline had similar overall survival in both arms.Conclusions: A 30% CTC decline after treatment from an initial count >= 5 cells/7.5 ml is independently associated with CRPC overall survival following abiraterone and chemotherapy, improving the performance of a multivariable model as early as 4 wk after treatment. This potential surrogate must now be prospectively evaluated.Patient summary: Circulating tumor cells (CTCs) are cancer cells that can be detected in the blood of prostate cancer patients. We analyzed changes in CTCs after treatment with abiraterone and chemotherapy in two large clinical trials, and found that patients who have a decline in CTC count have a better survival outcome. (C) 2016 European Association of Urology. Published by Elsevier B.V.
PB Elsevier science bv
SN 0302-2838
YR 2017
FD 2017-08-23
LK http://hdl.handle.net/10668/18775
UL http://hdl.handle.net/10668/18775
LA en
NO Lorente D, Olmos D, Mateo J, Bianchini D, Seed G, Fleisher M, et al. Decline in Circulating Tumor Cell Count and Treatment Outcome in Advanced Prostate Cancer. Eur Urol. 2016 Dec;70(6):985-992
DS RISalud
RD Apr 6, 2025