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. 2020 Mar 11;10(3):151.
doi: 10.3390/diagnostics10030151.

A Novel, Circulating Tumor Cell Enrichment Method Reduces ARv7 False Positivity in Patients With Castration-Resistant Prostate Cancer

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Free PMC article

A Novel, Circulating Tumor Cell Enrichment Method Reduces ARv7 False Positivity in Patients With Castration-Resistant Prostate Cancer

Takehiko Nakasato et al. Diagnostics (Basel). .
Free PMC article

Abstract

Background: The AR-V7 splice variant is a cause of castration-resistant prostate cancer (CRPC). However, testing for the presence of AR-V7 by real-time polymerase chain reaction (RT-PCR) shows AR-V7 positivity in healthy individuals. We hypothesized that the positivity reflects contamination by hematopoietic cells. We tried a novel circulating tumor cell (CTC) enrichment instrument, using Celsee, to clear hematopoietic cells.

Methods: We tested whole blood or Celsee-enriched samples for AR-V7 by RT-PCR, and included samples from 41 CRPC patients undergoing sequential therapy. We evaluated the associations between AR-V7 status and clinical factors. We evaluated factors affecting AR-V7 positivity.

Results: AR-V7 positivity was lower in Celsee-enriched than in whole blood specimens. AR-V7 and clinical factors did not predict the therapy effectiveness. We found no significant differences in the effectiveness of enzalutamide/abiraterone (Enz/Abi) upon AR-V7 evaluation. All AR-V7 positive patients had resistance to Enz/Abi. Docetaxel (DTX), cabazitaxel (CBZ), and Radium223 treatment showed no significant difference in the treatment effectiveness, regardless of AR-V7 presence. AR-V7 was more frequently positive than Extent of disease (EOD) 2 in cases with bone metastases.

Conclusion: Celsee CTC enrichment suppresses AR-V7 false positivity. All AR-V7 positive patients presented resistance to Enz/Abi. DTX, CBZ, and Radium223 were effective and remain treatment options. AR-V7 positivity should progressively appear in patients with advanced bone metastases.

Keywords: AR-V7; Abiraterone; Androgen receptors; Cabazitaxel; Docetaxel; Enzalutamide.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Presence of AR-V7 by PCR in the whole blood of healthy volunteers.
Figure 1
Figure 1
Presence of AR-V7 by PCR in the whole blood of healthy volunteers.
Figure 2
Figure 2
Confirmation of AR-V7 negativity in the whole blood of healthy volunteers after Celsee enrichment.
Figure 3
Figure 3
Confirmation of AR-V7 detection on whole blood of healthy volunteers spiked with Vcap (0, 10, 100) after Celsee enrichment.

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