Determining biomarkers of response to docetaxel for patients with metastatic castration-resistant prostate cancer (mCRPC) using circulating cell-free tumor DNA (ctDNA).

Authors

null

Daniel Khalaf

British Columbia Cancer Agency - Vancouver Centre, Vancouver, BC, Canada

Daniel Khalaf , Cameron Herberts , Gillian Vandekerkhove , Matti Annala , Kevin Beja , Bernhard J. Eigl , Christian K. Kollmannsberger , Lucia Nappi , Joanna Vergidis , Alexander William Wyatt , Kim N. Chi

Organizations

British Columbia Cancer Agency - Vancouver Centre, Vancouver, BC, Canada, Vancouver Prostate Centre, University of British Columbia, Vancouver, BC, CA, Vancouver Prostate Centre, University of British Columbia, Vancouver, BC, Canada, Institute of Biosciences and Medical Technology, Tampere, Finland, British Columbia Cancer Agency, Vancouver, BC, Canada, Vancouver Prostate Centre, University of British Columbia, Vnacouver, BC, Canada, British Columbia Cancer Agency - Vancouver Island Centre, Victoria, BC, Canada, BC Cancer Agency, Vancouver, BC, Canada

Research Funding

Other

Background: Docetaxel is associated with improved outcomes for mCRPC. There are currently no predictive molecular biomarkers for docetaxel to assist with patient selection. Methods: Patients commencing docetaxel for mCRPC between November 2015 and August 2017 were enrolled on a prospective cohort study evaluating circulating biomarkers. A plasma sample for ctDNA analysis was collected before initiation of docetaxel. Targeted sequencing of 73 prostate cancer-relevant genes was performed on leukocyte DNA (germline) and plasma cell-free DNA. Patient records were reviewed for baseline clinical characteristics, PSA response (≥ 50% decline from baseline), and time to PSA progression (TTPP) (PCWG3 criteria). Results: There were 33 patients enrolled; all patients had received prior abiraterone or enzalutamide and none had received prior taxanes. At baseline, the median age was 69.9 years, 30.3% had ECOG performance status 2, 66.7% had bone metastasis and 9.1% had liver metastases. The PSA response rate (RR) was 39.4% and 33.3% had a TTPP less than 3 months. 82% of patients had a ctDNA fraction >5%. Deleterious BRCA2 or ATM defects were present in 12.1% (4/33) of patients (3 somatic and 1 germline). TP53 alterations were identified in 39.4% (13/33), RB1 loss in 21.2% (7/33), PTEN loss in 21.2% (7/33), and Androgen Receptor (AR) amplification in 42.2% (14/33). PTEN deletion was associated with a trend toward inferior RR and TP53 had no discernible effect on PSA RR (Table). BRCA2/ATM defects were associated with a trend toward a lower rate of PSA progression within 3 months (Table). Conclusions: In this preliminary analysis, TP53 alterations had no discernible effect on efficacy of docetaxel chemotherapy. Accrual is ongoing in order to further clarify whether there is an association between PTEN, RB1, AR and BRCA2/ATM alterations and benefit from docetaxel.

AlterationRR (%)P (χ2)TTPP < 3 months (%)P (χ2)
BRCA2/ATM500.64300.129
TP5346.20.52230.10.794
RB142.90.83314.30.222
PTEN16.70.12642.90.542
AR28.60.16842.90.301
ctDNA fraction ˃ 20%33.30.66333.31.000

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2018 Genitourinary Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session A: Prostate Cancer

Track

Prostate Cancer,Prostate Cancer

Sub Track

Prostate Cancer - Advanced Disease

Citation

J Clin Oncol 36, 2018 (suppl 6S; abstr 260)

DOI

10.1200/JCO.2018.36.6_suppl.260

Abstract #

260

Poster Bd #

M14

Abstract Disclosures