Maas Moritz, Hegemann Miriam, Rausch Steffen, Bedke Jens, Stenzl Arnulf, Todenhöfer Tilman
Department of Urology, University Hospital Tuebingen, Hoppe-Seyler-Straße 3, Tuebingen 72076, Germany.
Asian J Androl. 2017 Aug 22;21(1):24-31. doi: 10.4103/aja.aja_29_17.
Circulating tumor cells (CTC) have become an important biomarker in patients with advanced prostate cancer. CTC count has been demonstrated to be a prognostic factor for overall survival in patients with metastatic castration-resistant prostate cancer (mCRPC). In localized prostate cancer, a clear correlation between CTC counts and clinicopathological risk parameters and outcome has not been observed. Currently, the focus of research is shifting from CTC enumeration towards molecular characterization of CTC leading to the discovery of markers predicting treatment response. The role of androgen receptor splice variants expressed by CTC as markers of resistance to abiraterone and enzalutamide has been assessed by various studies. The identification of CTC markers predicting treatment response represents a key step to guide the selection of treatment (e.g., abiraterone/enzalutamide vs taxanes), particularly in patients with mCRPC. As an alternative to CTC, the analysis of circulating tumor DNA has been shown to enable a noninvasive disease characterization having high potential to promote precision oncology.
循环肿瘤细胞（CTC）已成为晚期前列腺癌患者的重要生物标志物。CTC计数已被证明是转移性去势抵抗性前列腺癌（mCRPC）患者总生存的预后因素。在局限性前列腺癌中，尚未观察到CTC计数与临床病理风险参数及预后之间存在明确关联。目前，研究重点正从CTC计数转向CTC的分子特征分析，从而发现预测治疗反应的标志物。多项研究已评估了由CTC表达的雄激素受体剪接变体作为对阿比特龙和恩杂鲁胺耐药标志物的作用。鉴定预测治疗反应的CTC标志物是指导治疗选择（如阿比特龙/恩杂鲁胺与紫杉烷类）的关键步骤，尤其是在mCRPC患者中。作为CTC的替代方法，循环肿瘤DNA分析已被证明能够实现非侵入性疾病特征分析，具有极大潜力推动精准肿瘤学发展。
