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Sequencing Small Non-coding RNA from Formalin-fixed Tissues and Serum-derived Exosomes from Castration-resistant Prostate Cancer Patients
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Androgen Receptor Splice Variant 7 in Asian Patients With Metastatic Castration-Resistant Prostate Cancer
Daniel Ang1,2, Johan Chan1,2, Whee Sze Ong3
1Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore.
JCO Precision Oncology
|June 21, 2024
Summary
Androgen receptor splice variant 7 (ARV-7) positivity occurs in Asian patients with metastatic castrate-resistant prostate cancer (mCRPC) at rates similar to global populations. ARV-7 positive mCRPC patients show a trend towards worse outcomes, suggesting more aggressive disease.
Area of Science:
- Oncology
- Molecular Biology
- Genetics
Background:
- Androgen receptor splice variant 7 (ARV-7) is a key mechanism of resistance to hormonal therapy in metastatic castrate-resistant prostate cancer (mCRPC).
- ARV-7 positivity is linked to poorer clinical outcomes in mCRPC patients globally.
- Previous studies indicate a global incidence of ARV-7 positivity ranging from 17.8% to 28.8% upon progression to castrate resistance.
Purpose of the Study:
- To prospectively determine the incidence of ARV-7 positivity in Asian patients with mCRPC.
- To evaluate the impact of ARV-7 positivity on treatment outcomes in this specific patient population.
- To compare ARV-7 positivity rates in Asian mCRPC patients with previously reported global data.
Main Methods:
- Prospective enrollment of mCRPC patients from Southeast and East Asian centers prior to initiating androgen receptor signaling inhibitors or docetaxel.
- Assessment of ARV-7 status at baseline using three distinct commercial assays: AdnaTest Prostate Cancer platform, Clearbridge method, and IBN method.
- Evaluation of clinical outcomes, including prostate specific antigen (PSA) response rate, PSA progression-free survival (PFS), and overall survival (OS) at the time of progression.
Main Results:
- A total of 102 Asian mCRPC patients were analyzed, with a median age of 72 years.
- The incidence of ARV-7 positivity ranged from 14.3% to 33.7% among Asian patients, depending on the assay utilized.
- Patients with ARV-7 positivity at baseline demonstrated a numerically worse PSA progression-free survival (PFS) compared to ARV-7 negative patients.
Conclusions:
- The incidence of ARV-7 positivity in Asian mCRPC patients is comparable to that observed in the global population.
- ARV-7 positivity appears to be associated with more aggressive disease, indicated by numerically worse PSA PFS and overall survival (OS).
- Further prospective research is warranted to fully elucidate the prognostic significance of ARV-7 positivity in Asian mCRPC patients.
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