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雄激素受体核定位与转移性去势抵抗性前列腺癌患者循环肿瘤细胞(CTC)中的AR-V7 mRNA表达相关。

Androgen receptor nuclear localization correlates with AR-V7 mRNA expression in circulating tumor cells (CTCs) from metastatic castration resistance prostate cancer patients.

作者信息

Worroll Daniel, Galletti Giuseppe, Gjyrezi Ada, Nanus David M, Tagawa Scott T, Giannakakou Paraskevi

机构信息

Department of Medicine, Hematology/Oncology, Weill Cornell Medicine, New York, NY, United States of America. Author to whom any correspondence should be addressed.

出版信息

Phys Biol. 2019 Mar 22;16(3):036003. doi: 10.1088/1478-3975/ab073a.

Abstract

Androgen receptor (AR) signaling drives prostate cancer (PC) progression and remains active upon transition to castration resistant prostate cancer (CRPC). Active AR signaling is achieved through the nuclear accumulation of AR following ligand binding and through expression of ligand-independent, constitutively active AR splice variants, such as AR-V7, which is the most commonly expressed variant in metastatic CRPC (mCRPC) patients. Most currently approved PC therapies aim to abrogate AR signaling and activity by inhibiting this ligand-mediated nuclear translocation. In a prospective multi-institutional clinical study, we recently showed that taxane based chemotherapy is also capable of impairing AR nuclear localization (ARNL) in circulating tumor cells (CTCs) from CRPC patients, whereas taxane induced decreases in ARNL were associated with response. Thus, quantitative assessment of ARNL in CTCs can be used to monitor therapeutic response in patients and help guide clinical decisions. Here, we describe the development and implementation of quantitative high throughput (QHT) image analysis algorithms to aid in CTC identification and quantitative assessment of percent ARNL (%ARNL). We applied this algorithm to fifteen CRPC patients at the start of taxane chemotherapy, quantified %ARNL in CTCs, and correlated with expression of AR-V7 mRNA (from CTCs enriched via negative, CD45 depletion of peripheral blood) and with biochemical (prostate specific antigen; PSA) response to taxane chemotherapy. We found that CTCs from AR-V7 positive patients had higher baseline %ARNL compared to CTCs from AR-V7 negative patients, consistent with the constitutive nuclear localization of AR-V7. In addition, lower %ARNL in CTCs at baseline was associated with biochemical response to taxane chemotherapy. High inter- and intra-patient heterogeneity was also observed. As ARNL is required for active AR signaling, the QHT algorithms described herein can provide prognostic and/or predictive value in future clinical studies.

摘要

雄激素受体(AR)信号传导驱动前列腺癌(PC)进展,并且在转变为去势抵抗性前列腺癌(CRPC)后仍保持活跃。配体结合后,AR通过核积累以及通过表达不依赖配体、组成型激活的AR剪接变体(如AR-V7,它是转移性CRPC(mCRPC)患者中最常表达的变体)来实现活跃的AR信号传导。目前大多数获批的PC疗法旨在通过抑制这种配体介导的核转位来消除AR信号传导和活性。在一项前瞻性多机构临床研究中,我们最近表明,基于紫杉烷的化疗也能够损害CRPC患者循环肿瘤细胞(CTC)中的AR核定位(ARNL),而紫杉烷诱导的ARNL降低与反应相关。因此,对CTC中ARNL的定量评估可用于监测患者的治疗反应并帮助指导临床决策。在此,我们描述了定量高通量(QHT)图像分析算法的开发和实施,以辅助CTC识别和ARNL百分比(%ARNL)的定量评估。我们在紫杉烷化疗开始时将该算法应用于15例CRPC患者,对CTC中的%ARNL进行定量,并与AR-V7 mRNA(来自通过外周血阴性、CD45耗竭富集的CTC)的表达以及对紫杉烷化疗的生化(前列腺特异性抗原;PSA)反应相关联。我们发现,与AR-V7阴性患者的CTC相比,AR-V7阳性患者的CTC具有更高的基线%ARNL,这与AR-V7的组成型核定位一致。此外,基线时CTC中较低的%ARNL与对紫杉烷化疗的生化反应相关。还观察到患者间和患者内的高度异质性。由于活跃的AR信号传导需要ARNL,本文所述的QHT算法可在未来临床研究中提供预后和/或预测价值。

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