Phenotypic diversity of circulating tumour cells in patients with metastatic castration-resistant prostate cancer.
de Bono, JS
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To utilize a non-biased assay of circulating tumour cells (CTCs) in prostate cancer (PCa) patients in order to identify non-traditional CTC phenotypes potentially excluded by conventional detection methods reliant upon antigen and/or sized based enrichment.41 metastatic castration resistant prostate cancer (mCRPC) patients and 20 healthy volunteers were analysed on the Epic CTC Platform, via high throughput imaging of DAPI expression and CD45/cytokeratin (CK) immunofluorescence (IF) in all circulating nucleated cells plated on glass slides. IF for androgen receptor [AR] expression, and FISH for PTEN and ERG confirmed PCa origin of CTCs.Traditional (t) CTCs (CD45(-) /CK(+) /morphologically distinct) were identified in 100% mCRPC patients. Using the above markers, we identified non-traditional CTCs in mCRPC patients, including CK(-) and apoptotic CTCs. Small CTCs (≤WBC size) were identified in 98% of mCRPC patients. Total, traditional and non-traditional CTCs were significantly increased in deceased vs. living patients at 18 months; however only non-traditional CTCs associated with overall survival. Traditional and total CTC counts by the Epic platform in the mCRPC cohort were also significantly correlated with CTC counts by the CellSearch system.Heterogeneous non-traditional CTC populations that may be missed by other approaches are frequent in mCRPC; characterization of non-traditional CTCs may provide additional prognostic or predictive information. This article is protected by copyright. All rights reserved.
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Prostate Cancer Targeted Therapy Group
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BJU international, 2016