The androgen receptor splice variant AR-V7 has recently been discussed as a predictive biomarker for nonresponse to next-generation androgen deprivation therapy (ADT) in patients with castration-resistant prostate cancer. However, we recently identified one patient showing a response from abiraterone despite expression of AR-V7 in his circulating tumour cells (CTC).
Therefore, we precisely assessed the response in a cohort of 21 AR-V7 positive castration-resistant prostate cancer patients who had received therapy with abiraterone or enzalutamide. We detected a subgroup of six AR-V7 positive patients showing benefit from either abiraterone or enzalutamide. Their progression free survival was 26 d (censored) to 188 d. Four patients displayed a prostate-specific antigen decrease of >50%. When analysing prior therapies, we noticed that only one of the six patients had received next-generation ADT prior to CTC collection.
As a result, we conclude that AR-V7 status in CTC cannot entirely predict nonresponse to next generation ADT and AR-V7-positive patients should not be systematically denied abiraterone or enzalutamide treatment, especially as effective alternative treatment options are still limited.
A subgroup of patients can benefit from abiraterone and/or enzalutamide despite detection of AR-V7 splice variants in their circulating tumour cells.
Keywords: Abiraterone, Enzalutamide, Androgen receptor splice variant, AR-V7, Castration resistant prostate cancer.
a Clinic of Urology, University Hospital Muenster, Muenster, Germany
b Clinic of Urology, University Hospital Ulm, Ulm, Germany
c Gerhard-Domagk-Institute of Pathology, University Hospital Muenster, Muenster, Germany
Corresponding author. Department of Urology, Muenster University Medical Centre, Albert-Schweitzer-Campus 1, Building A 1, Muenster D-48149, Germany. Tel. +49 (0) 2 51/83-44609; Fax: +49 (0) 2 51/83-44619.
© 2016 European Association of Urology, Published by Elsevier B.V.