Clinical Relevance of Circulating Tumor Cells in Prostate Cancer Management
Abstract
:1. Introduction
2. Current Diagnostic and Monitoring Options
3. Liquid Biopsy: Detection of Cell-Free DNA and Circulating Tumor Cells
4. Prognostic Value of CTC in Metastatic Prostate Cancer
5. CTC Number as a Marker of Treatment Response
6. CTC Number as a Surrogate Survival Endpoint in Metastatic Prostate Cancer
7. CTC Number in the Monitoring of Prostate Cancer Outcomes
8. CTC Number at Early Stages of Prostate Cancer
9. Other Applications of CTC in Prostate Cancer
10. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Application | Pros | Cons |
---|---|---|
Prognostic factor in metastatic PC | Some evidence suggests that ≥5 CTC per 7.5 mL might be an unfavorable prognostic factor [18] | Only approximately 25% of patients with metastatic PC have ≥5 CTC per 7.5 mL [47,48] Some patients without CTC have a worse prognosis [49] Unclear whether the CTC number should be considered as a binary or continuous variable [49] |
Marker of treatment response in metastatic PC | Multiple clinical trials demonstrated that the CTC number (≥5 vs. <5 per 7.5 mL) correlates with survival after treatment [57,58,59,60,61,62,63] Inclusion of the CTC number as a response marker improved the discrimination and calibration of survival models [56] | None |
Surrogate survival endpoint in metastatic PC | CTC number (≥5 vs. <5 per 7.5 mL) was confirmed as an accurate surrogate survival endpoint in multiple clinical trials [64,65,66,67,68,69,70] | None |
Marker in the monitoring of PC outcomes | In some small studies, a higher CTC number correlated with worse survival and faster progression [72,73,74] | Not enough data from large studies confirming prognostic value of the CTC number No data justifying a change of treatment regimen in patients with without the CTC response/increase in the CTC number The cut-off value of ≥5 CTC per 7.5 does not seem to be applicable to clinical setting [18] Unclear whether a single change in CTC number is clinically relevant [71] |
Prognostic factor in localized PC | Theoretically suitable for the identification of patients with occult disseminated disease | CTC rarely found in patients with localized PC [75,76,77] CTC number does not seem to correlate with other clinicopathological parameters [75,76,77,78,79] Discrepancies in the CTC numbers obtained with various methods negatively affect cost-effectiveness of this parameter [81,82,83,84] |
Source of the genetic material of PC | CTC mirror accurately genetic status of cancer cells found in biopsy specimens [89] Genetic status of CRC was shown to be a predictor of prostate cancer aggressiveness [103] and therapeutic responses [90,91,92,93,94,95,96,97,98,99,100,101,102] | Not enough evidence confirming superiority of this method over conventional biopsy |
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Cieślikowski, W.A.; Antczak, A.; Nowicki, M.; Zabel, M.; Budna-Tukan, J. Clinical Relevance of Circulating Tumor Cells in Prostate Cancer Management. Biomedicines 2021, 9, 1179. https://doi.org/10.3390/biomedicines9091179
Cieślikowski WA, Antczak A, Nowicki M, Zabel M, Budna-Tukan J. Clinical Relevance of Circulating Tumor Cells in Prostate Cancer Management. Biomedicines. 2021; 9(9):1179. https://doi.org/10.3390/biomedicines9091179
Chicago/Turabian StyleCieślikowski, Wojciech A., Andrzej Antczak, Michał Nowicki, Maciej Zabel, and Joanna Budna-Tukan. 2021. "Clinical Relevance of Circulating Tumor Cells in Prostate Cancer Management" Biomedicines 9, no. 9: 1179. https://doi.org/10.3390/biomedicines9091179