The individual risk to progression is unclear for intermediate risk prostate cancer patients. To assess their risk to progression, we examined the level of genomic instability in circulating tumor cells (CTCs) using quantitative three-dimensional (3D) telomere analysis. Data of CTCs from 65 treatment-naïve patients with biopsy-confirmed D’Amico-defined intermediate risk prostate cancer were compared to radical prostatectomy pathology results, which provided a clinical endpoint to the study and confirmed pre-operative pathology or demonstrated upgrading. Hierarchical centroid cluster analysis of 3D pre-operative CTC telomere profiling placed the patients into three subgroups with different potential risk of aggressive disease. Logistic regression modeling of the risk of progression estimated odds ratios with 95% confidence interval (CI) and separated patients into “stable” vs. “risk of aggressive” disease. The receiver operating characteristic (ROC) curve showed an area under the curve (AUC) of 0.77, while prostate specific antigen (PSA) (AUC of 0.59) and Gleason 3 + 4 = 7 vs. 4 + 3 = 7 (p > 0.6) were unable to predict progressive or stable disease. The data suggest that quantitative 3D telomere profiling of CTCs may be a potential tool for assessing a patient’s prostate cancer pre-treatment risk.
Cancers. 2019 Jun 20*** epublish ***
Darrel Drachenberg, Julius A Awe, Aline Rangel Pozzo, Jeff Saranchuk, Sabine Mai
Manitoba Prostate Center, Cancer Care Manitoba, Section of Urology, Department of Surgery, University of Manitoba, Winnipeg, MB R3E 0V9, Canada. ., University of Manitoba, Cell Biology, Research Institute of Hematology and Oncology, CancerCare Manitoba, Winnipeg, MB R3E 0V9, Canada. ., University of Manitoba, Cell Biology, Research Institute of Hematology and Oncology, CancerCare Manitoba, Winnipeg, MB R3E 0V9, Canada. ., Manitoba Prostate Center, Cancer Care Manitoba, Section of Urology, Department of Surgery, University of Manitoba, Winnipeg, MB R3E 0V9, Canada. ., University of Manitoba, Cell Biology, Research Institute of Hematology and Oncology, CancerCare Manitoba, Winnipeg, MB R3E 0V9, Canada. .