Exploiting ctDNA measurements to assess response in metastatic castration-resistant prostate cancer

A new editorial article has been published in Oncotarget Volume 15 of July 2, 2024, entitled “Use of early measurements of circulating tumor DNA during treatment as an assessment of response in metastatic castration-resistant prostate cancer.”

In this new editorial, researchers SH Tolmeijer, E. Boerrigter, NP Van Erp, And Niven Mehra Researchers at Radboud University Medical Center discuss metastatic castration-resistant prostate cancer (mCRPC). mCRPC is deadly, but the number of life-prolonging systemic treatments available for mCRPC has increased over the years. Real-world data suggest that the most common first-line treatment for mCRPC was androgen receptor pathway inhibitor (ARPI) therapy, namely enzalutamide or abiraterone, although increasingly patients are now receiving ARPI and/or docetaxel for hormone-sensitive prostate cancer (HSPC).

Recent clinical trial data suggest a potential benefit of adding poly-ADP ribose polymerase inhibitors (PARPi) or lutetium-117 prostate-specific membrane antigen (LuPSMA) to first-line ARPI treatment of mCRPC in a subset of patients. Given that these different drug classes are associated with different toxicity profiles and significant costs, it is very important to identify patients who benefit durably from ARPI monotherapy and those who could potentially benefit from treatment intensification or switching.

“A study by Tolmeijer et al. in 2023, published in Clinical Cancer Research, suggests that detection of circulating tumor DNA (ctDNA) at baseline and 4 weeks after treatment initiation can predict durability of response to first-line ARPIs.”