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A blinded study across several hospitals confirmed that men whose circulating tumour cells carry the shortened androgen receptor live less long on hormone tablets, on two different tests that agree with each other four times in five.
PROPHECY was a multicentre, prospective, blinded study of men with high-risk metastatic castration-resistant prostate cancer starting abiraterone acetate or enzalutamide. The primary objective was to validate the prognostic significance of baseline circulating tumour cell AR-V7 using the Johns Hopkins University modified AdnaTest messenger RNA assay and the Epic Sciences nuclear-specific AR-V7 protein assay. One hundred and eighteen men were enrolled. AR-V7 detection by both assays was independently associated with shorter progression-free survival, hazard ratios 1.9 and 2.4, and with shorter overall survival, hazard ratios 4.2 and 3.5, after adjusting for circulating tumour cell number and clinical prognostic factors. AR-V7-positive men had confirmed PSA responses in 0 to 11% and soft-tissue responses in 0 to 6%. The observed percentage agreement between the two assays was 82%.
It turned a single-centre observation into a prospectively validated one and concluded that AR-V7-positive men should be offered alternatives to abiraterone and enzalutamide. It also quantified the honest limit: two assays for the same analyte disagree on nearly one sample in five.
Shares AR-V7 splice variant, AR-V7 splice variant, RNA splicing, Intravasation & circulating tumour cells.
Shares AR-V7 splice variant, PSA50 / PSA90 response, AR-V7 splice variant, RNA splicing.
Shares AR-V7 splice variant, Androgen receptor signalling, Resistance routes: how a blocked pathway comes back, Castration-resistant prostate cancer (CRPC).
Shares Androgen receptor signalling, Resistance routes: how a blocked pathway comes back, Castration-resistant prostate cancer (CRPC), Drug resistance (primary and acquired).
Shares Androgen receptor signalling, Resistance routes: how a blocked pathway comes back, Castration-resistant prostate cancer (CRPC), Drug resistance (primary and acquired).
Shares AR-V7 splice variant, Androgen receptor signalling, Resistance routes: how a blocked pathway comes back, Castration-resistant prostate cancer (CRPC).
Shares Androgen receptor signalling, Resistance routes: how a blocked pathway comes back, Castration-resistant prostate cancer (CRPC), Drug resistance (primary and acquired).
Shares Androgen receptor signalling, Resistance routes: how a blocked pathway comes back, Castration-resistant prostate cancer (CRPC), Drug resistance (primary and acquired).