A Phase 3 clinical trial has shown that a simple blood test can help doctors decide the best way to treat a man with advanced prostate cancer. According to the study, a circulating tumor cell or CTC count can predict which men may respond to standard treatment and live the longest and benefit from more aggressive new drug trials.

CTCs are tumor cells that break away from the primary tumor and spread throughout the body in the blood. They may be a potential indicator of early cancer metastasis and may occur before clinical cancer diagnosis. Researchers at the USC Norris Comprehensive Cancer Center in California said they have been looked at for prostate cancer before, but only in the later stages.

“Until now no one has looked at whether CTC counts can be used early on, when a man is first diagnosed with metastatic prostate cancer, to tell us whether he will survive long-term Will survive or short-term, or will progress with treatments,” said Dr. Amir Goldkorn, lead study author and associate director of translational science at the USC Norris Comprehensive Cancer Center in California.

Dr. Goldkorn’s team found that men who had higher levels of CTC in their blood had a shorter average survival time and a higher risk of death during the study period. Their disease can be controlled with treatment without getting worse for a short period of time. “When these guys walk in the door you can’t tell them apart,” Goldcorn said in a USC news release. “All their other variables and predictive factors seemed to be the same, and yet they had very, very different outcomes over time.”

How did the Phase 3 trials go?

For the study, part of the SWOG Cancer Research Network’s Phase 3 clinical trial, researchers said they used cell search – a specific and only Functional blood test used to detect CTC in cancer patients With metastatic breast, prostate, or colorectal cancer.

The study analyzed blood samples from 503 men with metastatic prostate cancer who were participating in a drug trial. The study said patients who had five or more CTCs in their blood samples had the worst outcomes. They were more than three times more likely to die during the study period than patients without CTCs, and their cancer was about 2.5 times more likely to progress.

They were also more likely to have a poor response to treatment, as measured by complete prostate-specific antigen (PSA) response. Men with five or more CTCs lived an average of 27.9 months after their blood tests, while men with one to four CTCs lived 56.2 months and men with no CTCs lived at least 78 months. (Half lived longer, half lived less.)

researchers say More CTC means faster cancer growthPoor response to standard treatment, and short survival time. The findings were published in the journal jama network openshow that measuring CTC levels at the start of therapy can predict long-term survival.

Goldkorn said, “We want to enrich these clinical trials with men who need extra help — who would really benefit from three drugs versus just two drugs, or from taking a new chemotherapy drug, even if it There may be more side effects.” , His team is now testing a new blood test that looks at the molecular composition of CTCs and tumor DNA in the blood, along with other factors. Their aim is to identify biomarkers that may be even better predictors of prognosis.

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