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Volume 20, Issue 3 (May 2018) 20, 230–237; 10.4103/aja.aja_1_18

Utility of cell-free nucleic acid and circulating tumor cell analyses in prostate cancer

Theodore Gourdin1, Guru Sonpavde2

1 Medical University of South Carolina, Charleston, SC 29425, USA
2 Dana Farber Cancer Institute, Genitourinary Oncology Section, Boston, MA 02215, USA

Correspondence: Dr. G Sonpavde (gurup_sonpavde@dfci.harvard.edu)

20-Mar-2018Date of Submission 14-Aug-2017 Date of Acceptance 28-Nov-2017 Date of Web Publication 20-Mar-2018


Prostate cancer is characterized by bone metastases and difficulty of objectively measuring disease burden. In this context, cell-free circulating tumor DNA (ctDNA) and circulating tumor cell (CTC) quantitation and genomic profiling afford the ability to noninvasively and serially monitor the tumor. Recent data suggest that ctDNA and CTC quantitation are prognostic for survival. Indeed, CTC enumeration using the CellSearch® platform is validated as a prognostic factor and warrants consideration as a stratification factor in randomized trials. Changes in quantities of CTCs using CellSearch also are prognostic and may be employed to detect a signal of activity of new agents. Molecular profiling of both CTCs and ctDNA for androgen receptor (AR) variants has been associated with outcomes in the setting of novel androgen inhibitors. Serial profiling to detect the evolution of new alterations may inform drug development and help develop precision medicine. The costs of these assays and the small quantities in which they are detectable in blood are a limitation, and novel platforms are required to address this challenge. The presence of multiple platforms to assay CTCs and ctDNA also warrants the consideration of a mechanism to allow comparison of data across platforms. Further validation and the continued development and standardization of these promising modalities will facilitate their adoption in the clinic.

Keywords: circulating; circulating tumor DNA; genomics; neoplastic cells; prostatic neoplasms

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Asian Journal of Andrology CN 31-1795/R ISSN 1008-682X  Copyright © 2023  Shanghai Materia Medica, Chinese Academy of Sciences.  All rights reserved.