According to a news report on the ScienceDaily web site, researchers in the UK have identified a subgroup of circulating tumor cells (CTCs) in patient’s blood that seem to be linked to risk for progression and spread of prostate cancer. This offers the possibility of a different type of test (at some point in the future) for risk of metastasis in higher-risk patients — both before and after first-line treatment.
According to the news release (issued by Cancer Research UK from the ongoing National Cancer Research Institute Cancer Conference in Liverpool), this research has been conducted by scientists at the Barts Cancer Institute at Queen Mary University in London. They were using a new type of cell separation technology (known as Parsortix™, developed by a UK-based company called ANGLE plc) to separate out the CTCs.
The lead author of the study, Yong-Jie Lu, is quoted as saying that:
If we’re able to replicate these studies in larger groups of people, we may be able to one day predict the risk of someone’s cancer spreading so they can make more informed treatment decisions.
Clearly there is a considerable amount of work that still needs to be done if this type of assay is going to become a useful clinical tool, but any progress on the ability to accurately predict which patients are at significant risk for metastatic as opposed to purely localized prostate cancer is always of considerable importance.
Filed under: Diagnosis, Living with Prostate Cancer, Management, Risk | Tagged: cell, circulating, CTC, metastasis, progression, risk, tumor |
THE "NEW" PROSTATE CANCER INFOLINK 
I have been trying to access this test for several months unsuccessfully. They are supposed to have a clinical trial here in the US but I haven’t heard any progress.
While this group is attempting to predict metastasis, at SWOG we are evaluating men in the S1216 trial who all have verified metastatic lesions but are hormone sensitive. Our findings, while preliminary, do trend that CTCs can be a prognostic tool. The higher the counts of CTCs in these men were associated with worse outcomes.
The question for the study here is: If CTCs are detectable, is it possible that mets already exist? It would stand to reason that these CTCs clearly indicate the potential that metastases already exist or that it may be reasonable to use imaging techniques to locate them. What we learned at SWOG is that the presence of metastases does not always indicate the presence of CTCs. But you would think that if a metastatic lesion is distant, then how else could it have got there than through the blood? Perhaps indicating we still have a bit more work to do on the sensitivity of CTC scanning. Still, it’s great research that may help change the standard of care at some point in the foreseeable future.
Tony:
I think a key question here is really whether all CTCs are the same, or whether there are subsets of CTCs that can be prognostic for specific events at particular points in time with high degrees of probability.