title: Circulating Tumor Cells as a Marker for Progression-free Survival in Metastatic Castration-naïve Prostate Cancer.
abstract: BACKGROUND
  Analysis of circulating tumor cells (CTC) is a promising prognostic marker in castration-resistant prostate cancer (CRPC). The aim of this study was to investigate CTC detection and phenotyping as prognostic biomarkers for response to primary androgen deprivation therapy (ADT) of metastatic prostate cancer (PC).
  
  
  METHODS
  PC patients presenting with a prostate specific antigen (PSA) >80 ng/ml and/or metastatic disease, intended for ADT were enrolled in the study. CTCs were analysed for expression of PSA prostate specific membrane antigen (PSMA) and epidermal growth factor receptor (EGFR) before and three months after ADT and related to progression.
  
  
  RESULTS
  At inclusion, 46 out of 53 patients (87%) were CTC-positive with a sensitivity and specificity for distant metastases (M1) of 98% and 75%, respectively. In patients with M1-disease, EGFR-detection in CTC was an independent prognostic marker for progression-free survival, whereas PSA and alkaline phosphatase serum levels, Gleason score, or T-stage were not. EGFR-positive patients had significantly shorter time to progression (5 months) compared to EGFR-negative patients (11 months) (P < 0.05).
  
  
  CONCLUSIONS
  In this explorative study, CTCs were detected in 98% of M1 patients and detection of EGFR in CTCs was strongly associated with poor outcome, which indicated that phenotypical analysis of CTC could be a promising prognostic marker of ADT-response in castration-naïve metastatic PC patients. Prostate 77:849-858, 2017. © 2017 Wiley Periodicals, Inc.
authors.affiliation: Sahlgrenska Cancer Center, Department of Urology, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Andreas
authors.initials: A
authors.lastname: Josefsson
authors.affiliation: Sahlgrenska Cancer Center, Department of Urology, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Linder
authors.affiliation: Department of Urology, Division of Urological Cancers, Skåne University Hospital, Lund University, Lund, Sweden.
authors.forename: Despina
authors.initials: D
authors.lastname: Flondell Site
authors.affiliation: Department of Urology, Division of Urological Cancers, Skåne University Hospital, Lund University, Lund, Sweden.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Canesin
authors.affiliation: Department of Urology, Division of Urological Cancers, Skåne University Hospital, Lund University, Lund, Sweden.
authors.forename: Anna
authors.initials: A
authors.lastname: Stiehm
authors.affiliation: Department of Urology, Division of Urological Cancers, Skåne University Hospital, Lund University, Lund, Sweden.
authors.forename: Aseem
authors.initials: A
authors.lastname: Anand
authors.affiliation: Department of Urology, Division of Urological Cancers, Skåne University Hospital, Lund University, Lund, Sweden.|Department of Translational Medicine, Division of Urological Cancers, Skåne University Hospital, Lund University, Lund, Sweden.
authors.forename: Anders
authors.initials: A
authors.lastname: Bjartell
authors.affiliation: Sahlgrenska Cancer Center, Department of Urology, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Jan-Erik
authors.initials: JE
authors.lastname: Damber
authors.affiliation: Sahlgrenska Cancer Center, Department of Urology, Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Karin
authors.initials: K
authors.lastname: Welén
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000378:metabolism; D002452:Cell Count / Q000379:methods; D018450:Disease Progression; D018572:Disease-Free Survival; D006801:Humans; D008297:Male; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating / Q000378:metabolism*; D009919:Orchiectomy / Q000379:methods*; D011237:Predictive Value of Tests; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood; D064129:Prostatic Neoplasms, Castration-Resistant / Q000097:blood / Q000175:diagnosis / Q000473:pathology / Q000628:therapy; D012680:Sensitivity and Specificity; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen
keywords: CTC; androgen deprivation therapy; epidermal growth factor receptor