The therapeutic approach in patients with metastatic castration-resistant prostate carcinoma (mCRPC) is still troubled by many factors and to date it's still difficult to define a tailored choice for these patients.
The skeleton is frequently affected by secondary localization so that the systemic radionuclide therapy emerged as a useful tool to palliate the metastatic pain.
Follow up of treatment and response is based on serial PSA titulations, bone scintigraphy, CT scan, analysis of tumor mass metabolism and pain/life quality control; however, the usefulness of these data appears limited by intrinsic peculiarities to the selected indicators.
Among the biomarkers used in oncology, the last years have seen the consolidation of the role of circulating tumor cells (CTCs) that proved to be effective early response markers, with a strong prognostic value independent from the type of treatment. CTCs are now routinely isolated from blood and their count relates well with survival in cancer patients. CTCs are considered as surrogates of metastatic cells and their characterization is assuming the title of a liquid biopsy, aiming to assist the tailoring of the therapeutic approach.
Despite those evidences, limits of the extensive use of CTCs assay in clinical practice are various. New methods aimed at improving the low detection efficiency are spreading so that by now there is not a consensus on the standard method to isolate the CTCs. The available technologies are expensive and require specific platforms and qualified personnel.
This study propose the optimization of an inexpensive and reliable method for CTCs count based on immunomagnetic isolation and cytofluorimetry detection method.
The expected results will allow us to develop a validated easy-to-access and cost-effective assay which could enable a wider use of CTCs count in clinical practice and provide a tool to plan a tailored therapeutic strategy and extending its clinical benefit also in metastatic patients.
Circulating tumor cells are now routinely isolated from blood, and measurement of CTC concentrations appears to correlate well with survival in cancer patients. The CTCs are considered as surrogates of metastatic cells and their characterization is assuming the title of a liquid biopsy, aimed at facilitating the tailoring of the therapeutic approach. The strong independent prognostic value of CTCs count has also been made now firmly integrated into randomized clinical trials as a cumulative survival surrogate end-point.
Despite these evidences, limits of the extensive use of CTCs assay in clinical practice are various.
The available technologies for CTC detection are often expensive and require specific equipment and qualified technical personnel.
This study covers a hot topic in the field of translational biology and proposes the optimization of an inexpensive, simple, and reliable method for CTCs detection and enumeration. The cytofluorimetric assay does not require highly specialized laboratories, and the costs are not the ¿stumbling block¿.
The availability of an easy-to-access and cost-effective platform for the CTCs count, qualified for a performance comparable to that of the most complex and advanced techniques, could allow a wider use in clinical practice of this biomarker and could give a critical data to plan a personalized therapeutic approach in order to maximize its clinical benefit also in metastatic patients.