The analysis of circulating tumor cells (CTCs) are not easy and are not yet part of the routine care, among the reasons that make this analysis difficult is the indivduation of these cells among millions in a blood sample.
However, in June 2018 a study reported that decisions regarding treatments for aggressive prostate cancers taken by CTC testing have led to an increase in increase lifespan in men.
The treatment of metastatic prostate cancer generally consists in the use of drugs that interfere with how a man’s body makes or uses testosterone, (which would be an androgen) that accelerates the spread of the cancer.
If the normal hormone blocking treatment does not work, the doctors can proceed with the taxanes (a chemotherapeutic agent) or try another hormone blocker that will act on the cancer’s cell androgen receptor.
These alternative hormone, known as androgen receptor signaling (ARS) inhibitors, include two agents, enzalutamide and abiraterone. The problem is that these agents work unless the androgen receptor has a genetic mutation called AR-V7, which unfortunately makes the cancer more aggressive.
The scientists then began to investigate whether screening for AR-V7 in CTC’s could lead to the setting of better treatment.
The team of scientists at the Memorial Sloan Kettering Cancer Center in New York investigated it. They collected 142 blood samples from men with metastatic prostate cancer, who did not respond to the usual therapies.
Following the CTC’s screening for half of the patients the treatment used was with ARS inhibitors, for the other half with Taxanes.
People who had tested for AR-V7 were negative, and treated with ARS Inhibitors had a higher median survival.
People who had tested for AR-V7 were positive, had a higher median survival when they were treated with taxanes.
The results show that the detection of AR-V7 can be very important in order to choose the best treatment for patients and increase the knowledge of possible treatments for this type of cancer.
If you want to know more details about this topic, you can find more information in the Harvard Health Blog’s article.