AI Article Synopsis

  • Chemohormonal therapy is the standard treatment for metastatic hormone-sensitive prostate cancer (mHSPC), but there are currently no reliable biomarkers to inform treatment choices.
  • In a study of 66 mHSPC patients, researchers used serial circulating tumor DNA (ctDNA) sequencing to predict the effectiveness of this therapy after one cycle of treatment.
  • The results showed that patients with increased ctDNA levels or new genetic alterations had a shorter time to disease progression, suggesting ctDNA sequencing could help clinicians make better treatment decisions.

Article Abstract

Chemohormonal therapy is a standard treatment for metastatic hormone-sensitive prostate cancer (mHSPC); however, there are no biomarkers to guide clinical decisions regarding therapeutic options. We aimed to evaluate the clinical utility of serial circulating tumor DNA (ctDNA) sequencing in early prediction of the efficacy of chemohormonal therapy in patients with mHSPC. We conducted a retrospective observational study of 66 patients with mHSPC receiving chemohormonal therapy who underwent serial targeted gene-panel ctDNA sequencing. Peripheral blood samples were collected before treatment and after one cycle of chemotherapy. Kaplan-Meier and log-rank analyses were used to analyze the association between ctDNA status and disease progression-free survival. Serial changes in the ctDNA fraction and genetic alterations were also observed. After one cycle of chemotherapy, 23 (34.8%) patients displayed elevated ctDNA levels, whereas the other patients (65.2%, n = 43) did not. The median time to castration resistance in the group with reduced ctDNA levels was significantly longer than that in the group with increased ctDNA levels (17.70 vs. 8.43 months [mo], p < 0.001). Interestingly, patients with de novo alterations in homologous recombination pathway genes after treatment experienced a shorter time to castration resistance than that experienced by the remaining patients (8.02 vs. 13.20 mo, p = 0.011). The increased ctDNA levels or de novo alterations detected in homologous recombination pathway genes are a harbinger of disease progression. Early serial ctDNA sequencing could aid clinicians in making accurate treatment decisions.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10236461PMC
http://dx.doi.org/10.1016/j.tranon.2023.101701DOI Listing

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