GU Cancers 2022 | ctDNA level variation as an early predictor of survival in patients with mCRPC

Vincenza Conteduca, MD, PhD, Scientific Institute of Romagna for the Study and Treatment of Tumors, Meldola, Italy, discusses a recent study on the association between ctDNA fraction, bone metastasis pattern, and survival in patients with metastatic castration-resistant prostate cancer (mCRPC). Around 90% of patients with mCRPC have bone metastases so identifying an early biomarker for treatment efficacy is greatly needed. The study used next generation sequencing to assess ctDNA fraction in patients at baseline and after 3 months of treatment with enzalutamide or abiraterone. The results showed that patients with bone oligometastatic disease had a low ctDNA fraction, whereas patients with diffuse bone metastatic disease had a high level of ctDNA fraction. The assessment of ctDNA after treatment was used to investigate the association between variations in ctDNA level and survival. These results indicated that patients with high variation in ctDNA levels from baseline after 3 months of treatment had worse overall survival (OS) and progression-free survival (PFS). After a multivariable analysis, the study suggested that ctDNA fraction variation was an independent predictor of OS and radiographic PFS. This interview took place at the American Society of Clinical Oncology (ASCO) Genitourinary Cancers Symposium 2022 in San Francisco, CA.