CTCs as a prognostic tool in advanced prostate cancer

Circulating tumor cells (CTCs) have been approved for marketing by the US Food and Drug Administration as a useful prognostic tool for the management of patients with advanced prostate cancer. To date, however, the optimal clinical cut-off levels of CTCs has not been determined, and the predictive value of CTCs in the setting of low-burden advanced prostate cancer has not been evaluated.

Goodman et al. have reported data on CTC levels in 100 patients with castration-resistant prostate cancer (CRPC) and correlated these data with clinicopathologic characteristics and conventional biomarkers, such as PSA and lactate dehydrogenase (LDH) levels. All patients were followed for up to 26 months, and overall survival status was documented.

  • 49/100 patients (49 percent) were alive at the end of the study.
  • CTC counts correlated well with overall survival (P < 0.001) but were also tightly interrelated to other biomarkers.
  • In this study a level of 4 CTCs/7.5 ml appears to offer an optimal cut-off value with respect to survival outcomes and risk for metastatic disease.
  • LDH level and CTC counts were independently prognostically significant on multivariate analysis.

It is clear that baseline CTC values provide important prognostic information and have specific predictive value in assessment of risk for metastatic disease. However, we are still learning how to use the CTC test to it’s greatest capability in routine clinical practice. Patients and their doctors should be cautious about overinterpretation of the results of CTC tests at this time.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.

%d bloggers like this: