Recent advances in circulating tumor cells and cell-free DNA in metastatic prostate cancer: a review

ABSTRACT

Introduction: The treatment landscape of metastatic prostate cancer has changed dramatically over the past five years. As new discoveries are made and further novel therapies become available, there is a heightened urgency to develop biomarkers that can guide prognoses and predict therapy responses. Circulating tumor cells (CTCs) and cell-free circulating tumor DNA (ctDNA) in the blood have emerged as potential promising tumor avatars.

Areas covered: In this review, we describe technological breakthroughs and clinical implementation of the CTCs and ctDNA. We also discuss the key challenges that must be overcome before circulating blood-based biomarkers can be universally adopted into the management of patients with metastatic prostate cancer.

Expert commentary: Both CTCs and ctDNA have the potential to be incorporated into routine patient care, with increasing numbers of prospective trials incorporating them into clinical designs. CTCs and ctDNA will thus have an increasingly valuable role in augmenting our understanding of prostate cancer at a molecular level, aiding in prognostication of prostate cancer patients, acting as a surrogate for OS in clinical trials, and helping us prioritize our treatment selections by elucidating resistance mechanisms.

KEYWORDS:

• Cell-free circulating tumor DNA
• circulating tumor cells
• cfDNA
• ctDNA
• CTC

Declaration of interest

S Parimi has received honoraria from Pfizer, Astellas, Janssen, Amgen, and Novartis, and has sat on the advisory board for Astellas and Janssen. JJ Ko has received honoraria from AstraZeneca and Janssen, and has sat on the advisory board for AstraZeneca and Merck. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Additional information

Funding

This manuscript has not been funded.