Expression of AR-V7 in Circulating Tumour Cells Does Not Preclude Response to Next Generation Androgen Deprivation Therapy in Patients with Castration Resistant Prostate Cancer |
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Authors: | Christof Bernemann Thomas J. Schnoeller Manuel Luedeke Konrad Steinestel Martin Boegemann Andres J. Schrader Julie Steinestel |
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Affiliation: | 1. Clinic of Urology, University Hospital Muenster, Muenster, Germany;2. Clinic of Urology, University Hospital Ulm, Ulm, Germany;3. Gerhard-Domagk-Institute of Pathology, University Hospital Muenster, Muenster, Germany |
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Abstract: | The androgen receptor splice variant AR-V7 has recently been discussed as a predictive biomarker for nonresponse to next-generation androgen deprivation therapy (ADT) in patients with castration-resistant prostate cancer. However, we recently identified one patient showing a response from abiraterone despite expression of AR-V7 in his circulating tumour cells (CTC).Therefore, we precisely assessed the response in a cohort of 21 AR-V7 positive castration-resistant prostate cancer patients who had received therapy with abiraterone or enzalutamide. We detected a subgroup of six AR-V7 positive patients showing benefit from either abiraterone or enzalutamide. Their progression free survival was 26 d (censored) to 188 d. Four patients displayed a prostate-specific antigen decrease of >50%. When analysing prior therapies, we noticed that only one of the six patients had received next-generation ADT prior to CTC collection.As a result, we conclude that AR-V7 status in CTC cannot entirely predict nonresponse to next generation ADT and AR-V7-positive patients should not be systematically denied abiraterone or enzalutamide treatment, especially as effective alternative treatment options are still limited.Patient summaryA subgroup of patients can benefit from abiraterone and/or enzalutamide despite detection of AR-V7 splice variants in their circulating tumour cells. |
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Keywords: | Abiraterone Enzalutamide Androgen receptor splice variant AR-V7 Castration resistant prostate cancer |
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