Blood-based biomarkers are critical in metastatic prostate cancer, where characteristic bone metastases are not readily sampled, and they may enable risk stratification in localized disease. We established a sensitive and high-throughput strategy for analyzing prostate circulating tumor cells (CTCs) using microfluidic cell enrichment followed by digital quantitation of prostate-derived transcripts. In a prospective study of 27 metastatic castration-resistant prostate cancer patients treated with first-line abiraterone, pretreatment elevation of the digital CTCM Score identifies a high risk population with poor overall survival (HR 6.0, P=0.01) and short radiographic progression-free survival (HR 3.2, P=0.046). Expression of HOXB13 in CTCs identifies 6/6 patients with ≤12 months survival, with a subset also expressing the AR-V7 splice variant. In a second cohort of 34 men with localized prostate cancer, an elevated preoperative CTCL Score predicts microscopic dissemination to seminal vesicles and/or lymph nodes (P<0.001). Thus, digital quantitation of CTC-specific transcripts enables noninvasive monitoring that may guide treatment selection in both metastatic and localized prostate cancer.
Cancer discovery. 2018 Jan 04 [Epub ahead of print]
David T Miyamoto, Richard J Lee, Mark Kalinich, Joseph LiCausi, Yu Zheng, Tianqi Chen, John D Milner, Erin Emmons, Uyen Ho, Katherine Broderick, Erin Silva, Sarah Javaid, Tanya Todorova Kwan, Xin Hong, Douglas M Dahl, Francis J McGovern, Jason A Efstathiou, Matthew R Smith, Lecia V Sequist, Ravi Kapur, Chin-Lee Wu, Shannon L Stott, David T Ting, Anita Giobbie-Hurder, Mehmet Toner, Shyamala Maheswaran, Daniel A Haber
Massachusetts General Hospital Cancer Center, Harvard Medical School., Dana Farber Cancer Institute., Harvard Medical School, Massachusetts General Hospital Cancer Center., Center for Bioengineering in Medicine, Harvard Medical School., Massachusetts General Hospital Cancer Center, Harvard Medical School .