Despite advancements in the early-stage detection and expansion of treatments for prostate cancer (PCa), patient mortality rates remain high in patients with aggressive disease and the overtreatment of indolent disease remains a major issue. Prostate-specific antigen (PSA), a standard PCa blood biomarker, is limited in its ability to differentiate disease subtypes resulting in the overtreatment of non-aggressive indolent disease. Here we assess engorged cancer-associated macrophage-like cells (CAMLs), a ≥50 µm, cancer-specific, polynucleated circulating cell type found in the blood of patients with PCa as a potential companion biomarker to PSA for patient risk stratification. We found that rising PSA is positively correlated with increasing CAML size (r = 0.307, p = 0.004) and number of CAMLs in circulation (r = 0.399, p < 0.001). Over a 2-year period, the presence of a single engorged CAML was associated with 20.9 times increased likelihood of progression (p = 0.016) in non-metastatic PCa, and 2.4 times likelihood of progression (p = 0.031) with 5.4 times likelihood of death (p < 0.001) in metastatic PCa. These preliminary data suggest that CAML cell monitoring, in combination with PSA, may aid in differentiating non-aggressive from aggressive PCas by adding biological information that complements traditional clinical biomarkers, thereby helping guide treatment strategies.
Cancers. 2023 Jul 22*** epublish ***
Daniel J Gironda, Raymond C Bergan, R Katherine Alpaugh, Daniel C Danila, Tuan L Chuang, Brenda Y Hurtado, Thai Ho, Daniel L Adams
Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA., Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198, USA., Fox Chase Cancer Center, Philadelphia, PA 19111, USA., Genitourinary Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA., Mayo Clinic Cancer Center, Phoenix, AZ 85054, USA., Creatv MicroTech, Inc., Monmouth Junction, NJ 08852, USA.