In this multi-institutional cohort study, 142 patients with metastatic castration-resistant prostate cancer treated with either taxanes or androgen receptor signaling (ARS) inhibitors were observed for up to 4.3 years. Pretherapy circulating tumor cell status and treatment type were associated with overall survival. Patients with AR-V7–positive circulating tumor cells had superior overall survival with taxanes vs ARS inhibitors, whereas patients with AR-V7–negative circulating tumor cells had superior overall survival with ARS inhibitors vs taxanes.
Among the 142 patients in the study (mean [SD] age, 69.5 [9.6] years), 70 were designated as high risk by conventional prognostic factors. In this high-risk group, patients positive for AR-V7 who were treated with taxanes had superior overall survival relative to those treated with ARS inhibitors (median overall survival, 14.3 vs 7.3 months; hazard ratio, 0.62; 95% CI, 0.28-1.39; P = .25). Patients negative for AR-V7 who were treated with ARS inhibitors had superior overall survival relative to those treated with taxanes (median overall survival, 19.8 vs 12.8 months; hazard ratio, 1.67; 95% CI, 1.00-2.81; P = .05).
https://jamanetwork.com/journals/jamaoncology/fullarticle/2686031
