A non-invasive DNA blood test can identify patients with metastatic castration-resistant prostate cancer (mCRPC) most likely to benefit from 223Ra radiopharmaceutical therapy and monitor their progress throughout treatment, according to a new study published in the July issue. nuclear medicine journal. Incorporating this new approach to DNA profiling into clinical practice has the potential to improve patient selection, enable early detection of treatment resistance, and optimize individualized management of prostate cancer patients.
223Ra dichloride is a bone-targeted radiopharmaceutical therapy that has been shown to improve overall survival and quality of life in patients with mCRPC. However, clinical outcomes with 223Ra vary among patients, and no reliable biomarkers have been established to predict or monitor treatment response. Therefore, there remains an unmet need for reliable prognostic prediction and biomarker monitoring in patients receiving 223Ra.
Circulating tumor DNA (ctDNA) testing, a simple blood test, has emerged as a promising approach to advance precision oncology. Compared to tumor biopsies, ctDNA is less invasive and can be collected repeatedly, providing a real-time genomic snapshot of the tumor and its heterogeneity, which may provide valuable information in the context of 223Ra therapy. ”
Masaki Shioda, Doctor of Medicine, Associate Professor, Department of Urology, Kyushu University Graduate School of Medical Science, Associate Professor (Fukuoka Prefecture)
As there is a lack of research on ctDNA profiling in 223Ra radiopharmaceutical treatment for mCRPC, Shioda et al sought to investigate its genomic landscape and clinical utility. The study included 93 mCRPC patients who underwent targeted ctDNA testing using an 88-gene panel before and after receiving 223Ra therapy. Associations between ctDNA profiles and clinical outcomes including biomarker responses, radiographic progression-free survival, and overall survival were analyzed.
Patients with higher amounts of tumor DNA in their blood, or whose ctDNA testing detected certain genetic changes such as TP53, PTEN, and changes in cell cycle pathways, were found to have worse outcomes. This analysis also showed that changes in tumor DNA during treatment reflect treatment response and disease course.
“223Ra is an important treatment for prostate cancer that has metastasized to the bone, but not all patients benefit equally,” Professor Shioda said. “Our findings suggest that blood-based genomic testing may help identify patients who are more or less likely to benefit from treatment. This may allow physicians to more carefully select treatments and monitor patients more closely with the aim of providing more personalized care.”
sauce:
Society of Nuclear Medicine and Molecular Imaging
Reference magazines:
DOI: 10.2967/jnumed.126.272073
