Abstract
Management of localized and advanced prostate cancer benefits from several therapeutic options with a surprising improvement in terms of clinical outcome. The selection of patients more likely to benefit from a specific approach still remains a key issue as well as the early identification of patients with aggressive disease which could benefit from a more aggressive treatment strategy. The lack of reliable bio-marker in castration resistant setting able to monitor response to treatment and early inform about tumor progression is an emerging issue. Accordingly, circulating DNA and circulating tumor cells appears a promising and attractive approach despite to date practical applications of these techniques are few and not validated. The aim of this review of the literature is to explore current knowledge on liquid biopsy in prostate cancer focusing on possible future applications.
Highlights
Prostate Cancer (PCa) represents the most common adult malignancies ranking as one of the major cause of cancer related death in men [1]
The management of localized stages could range from a first instance no invasive approach to a radical approach by surgery, external radiation treatment, a combination of both of them or brachytherapy with or without an adjuvant androgen deprivation therapy (ADT) [2,3,4,5,6,7,8]
Pre-planned analyses of large phase III trials: SWOG 20421, COU-AA-301 and AFFIRM confirmed the prognostic rule of circulating tumor cell (CTC) as independent factor related to overall survival (OS) [51,52,53]
Summary
Prostate Cancer (PCa) represents the most common adult malignancies ranking as one of the major cause of cancer related death in men [1]. Pre-planned analyses of large phase III trials: SWOG 20421 (docetaxel with or without atrasentain in mCRPC patients), COU-AA-301 (in which a score composed by LDH levels and CTCs divided patients in 3 different subgroups with favorable, intermediate and poor prognosis) and AFFIRM (enzalutamide in patients with mCRPC progressed to chemotherapy) confirmed the prognostic rule of CTCs as independent factor related to OS [51,52,53] None of these studies demonstrated an association between CTCs number and response to treatment and so the role of CTCs in this setting still remains unclear
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