Circulating tumor cells as biomarkers in prostate cancer Journal Article


Authors: Danila, D. C.; Fleisher, M.; Scher, H. I.
Article Title: Circulating tumor cells as biomarkers in prostate cancer
Abstract: Unmet needs in prostate cancer drug development and patient management are the ability to monitor treatment effects and to identify therapeutic targets in a tumor at the time treatment is being considered. This review focuses on establishing analytically valid biomarkers for specific contexts of use in patients with castration-resistant prostate cancer (CRPC), emphasizing a biomarker currently in clinical use, circulating tumor cells (CTC). The FDA Critical Path provides a road map for these investigations, which, if followed, will facilitate the incorporation of these types of assays into clinical decision-making. CTC enumeration at baseline and post-treatment is prognostic of survival, with no threshold effect, and the shedding of cells into the circulation represents an intrinsic property of the tumor, distinct from extent of disease. The clinical utility of monitoring CTC changes with treatment, as an efficacy-response surrogate biomarker of survival, is currently being tested in large phase III trials, with the novel antiandrogen therapies abiraterone acetate and MDV3100. Molecular determinants can be identified and characterized in CTCs as potential predictive biomarkers of tumor sensitivity to a therapeutic modality. Additionally, we discuss novel technologies to enrich and characterize CTCs from more patients, the potential clinical uses of CTCs in determining prognosis and monitoring treatment effects, and CTCs as a source of tissue to identify predictive markers of drug sensitivity to guide treatment selection. Prospective studies, designed around the biomarker itself and the specific clinical context for which it is applied, are needed to further assess the role of these and novel markers in clinical practice. ©2011 AACR.
Keywords: cancer chemotherapy; cancer survival; review; placebo; drug efficacy; ipilimumab; patient monitoring; chemosensitivity; cancer resistance; docetaxel; drug response; clinical decision making; abiraterone acetate; provenge; circulating tumor cell; castration resistant prostate cancer; 4 [3 [4 cyano 3 (trifluoromethyl)phenyl] 5,5 dimethyl 4 oxo 2 thioxo 1 imidazolidinyl] 2 fluoro n methylbenzamide; orteronel
Journal Title: Clinical Cancer Research
Volume: 17
Issue: 12
ISSN: 1078-0432
Publisher: American Association for Cancer Research  
Date Published: 2011-06-15
Start Page: 3903
End Page: 3912
Language: English
DOI: 10.1158/1078-0432.ccr-10-2650
PROVIDER: scopus
PUBMED: 21680546
PMCID: PMC3743247
DOI/URL:
Notes: --- - "Export Date: 17 August 2011" - "CODEN: CCREF" - "Source: Scopus"
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  1. Martin Fleisher
    312 Fleisher
  2. Howard Scher
    1130 Scher
  3. Daniel C Danila
    154 Danila