{"entity":{"id":"paper-scher-nuclear-arv7-taxane-vs-arsi-jama-oncol-2018","kind":"paper","name":"Nuclear-localised androgen receptor splice variant 7 in circulating tumour cells as a predictive biomarker in castration-resistant prostate cancer","aka":[],"tldr":"A blinded three-hospital study found that men with the shortened receptor in their circulating tumour cells lived roughly twice as long on chemotherapy as on another hormone tablet, and that men without it did better the other way round.","summary":"A blinded correlative study conducted between December 2012 and September 2016 included 142 men with histologically confirmed metastatic castration-resistant prostate cancer treated at Memorial Sloan Kettering Cancer Center, the Royal Marsden or the London Health Sciences Centre. Blood samples were taken before an androgen receptor signalling inhibitor or a taxane given as second-line or later therapy for progressing disease, and nuclear-localised AR-V7 protein in circulating tumour cells was measured on a validated assay. Among the 70 men designated high risk by conventional prognostic factors, AR-V7-positive men treated with taxanes had a median overall survival of 14.3 months against 7.3 months for those treated with receptor signalling inhibitors (hazard ratio 0.62), while AR-V7-negative men treated with receptor signalling inhibitors had a median overall survival of 19.8 months against 12.8 months on taxanes (hazard ratio 1.67).","asOf":"2026-09-25","links":[{"label":"Scher et al., JAMA Oncol 2018: nuclear-localised AR-V7 protein in circulating tumour cells and the taxane against androgen receptor signalling inhibitor choice (142 patients)","url":"https://doi.org/10.1001/jamaoncol.2018.1621"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/29955787/"}],"tags":[],"related":[],"cancers":["prostate","prostate-mcrpc"],"sections":[],"technologies":["liquid-biopsy"],"targets":["androgen-receptor"],"drugs":[],"companies":[],"institutions":[],"pathways":["ar-signaling","rna-splicing","intravasation-ctc-survival"],"terms":["ar-v7","liquid-biopsy","castration-resistance","resistance"],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["jama-oncology"],"dependsOn":[],"notes":[],"journal":"JAMA Oncology","year":2018,"doi":"10.1001/jamaoncol.2018.1621","pmid":"29955787","authors":"Scher HI, Graf RP, Schreiber NA, et al.","paperType":"observational","findings":["AR-V7-positive high-risk men: median overall survival 14.3 months on a taxane against 7.3 months on a receptor signalling inhibitor.","AR-V7-negative men: 19.8 months on a receptor signalling inhibitor against 12.8 months on a taxane (hazard ratio 1.67).","The treatment-selection effect was confined to the conventionally high-risk group of 70 men."],"whatItMeans":"It is the clearest evidence in prostate cancer that a blood biomarker can point to one treatment class over another, and the reason AR-V7 is discussed in guidelines despite being in no label.","caveats":["Not randomised: treatment was chosen by clinicians, so confounding by indication cannot be excluded.","The confidence interval for the positive group crossed one (hazard ratio 0.62, 0.28 to 1.39).","One hundred and forty-two men across three centres with a laboratory-developed test."],"changedPractice":false,"participants":142},"route":"/key-papers/paper-scher-nuclear-arv7-taxane-vs-arsi-jama-oncol-2018/","neighbours":{"cancer":[{"id":"prostate-mcrpc","kind":"cancer","name":"Metastatic castration-resistant prostate cancer","route":"/cancers/prostate-mcrpc/"},{"id":"prostate","kind":"cancer","name":"Prostate cancer","route":"/cancers/prostate/"}],"technology":[{"id":"liquid-biopsy","kind":"technology","name":"Liquid biopsy (ctDNA)","route":"/technologies/liquid-biopsy/"}],"target":[{"id":"androgen-receptor","kind":"target","name":"Androgen receptor","route":"/targets/androgen-receptor/"}],"pathway":[{"id":"ar-signaling","kind":"pathway","name":"Androgen receptor signalling","route":"/pathways/ar-signaling/"},{"id":"intravasation-ctc-survival","kind":"pathway","name":"Intravasation & circulating tumour cells","route":"/pathways/intravasation-ctc-survival/"},{"id":"rna-splicing","kind":"pathway","name":"RNA splicing","route":"/pathways/rna-splicing/"}],"term":[{"id":"ar-v7","kind":"term","name":"AR-V7 splice variant","route":"/terms/ar-v7/"},{"id":"castration-resistance","kind":"term","name":"Castration-resistant prostate cancer (CRPC)","route":"/terms/castration-resistance/"},{"id":"resistance","kind":"term","name":"Drug resistance (primary and acquired)","route":"/terms/resistance/"}],"journal":[{"id":"jama-oncology","kind":"journal","name":"JAMA Oncology","route":"/journals/jama-oncology/"}],"biomarker":[{"id":"ar-v7-splice-variant","kind":"biomarker","name":"AR-V7 splice variant","route":"/biomarkers/ar-v7-splice-variant/"}]}}