Conteduca, VincenzaWetterskog, DSharabiani, M. T. AGrande, EFernandez-Perez, M. PJayaram, ASalvi, SCastellano, DRomanel, ALolli, CCasadio, VGurioli, GAmadori, DFont, AlbertVazquez-Estevez, SGonzalez del Alba, AranzazuAutor/a del sistema sanitario público de las Islas Baleares OrcidMellado, BFernandez-Calvo, OMendez-Vidal, M. JCliment, M. ADuran, IgnacioGallardo, ERodriguez, ASantander, CSaez, M. IPuente, JTandefelt, D. GasiWingate, ADearnaley, DDemichelis, FDe Giorgi, UgoGonzalez-Billalabeitia, EAttard, GPREMIERE CollaboratorsSpanish Oncology Genitourinary Grp2024-07-112024-07-112017-07Conteduca V, Wetterskog D, Sharabiani MTA, Grande E, Fernandez-Perez MP, Jayaram A, et al. Androgen receptor gene status in plasma DNA associates with worse outcome on enzalutamide or abiraterone for castration-resistant prostate cancer: a multi-institution correlative biomarker study. Ann Oncol. 2017 Jul;28(7):1508-16.0923-7534http://hdl.handle.net/20.500.13003/9759http://hdl.handle.net/20.500.12105/20435Background: There is an urgent need to identify biomarkers to guide personalized therapy in castration-resistant prostate cancer (CRPC). We aimed to clinically qualify androgen receptor (AR) gene status measurement in plasma DNA using multiplex droplet digital PCR (ddPCR) in pre- and post-chemotherapy CRPC. Methods: We optimized ddPCR assays for AR copy number and mutations and retrospectively analyzed plasma DNA from patients recruited to one of the three biomarker protocols with prospectively collected clinical data. We evaluated associations between plasma AR and overall survival (OS) and progression-free survival (PFS) in 73 chemotherapy-naive and 98 postdocetaxel CRPC patients treated with enzalutamide or abiraterone (Primary cohort) and 94 chemotherapy-naive patients treated with enzalutamide (Secondary cohort; PREMIERE trial). Results: In the primary cohort, AR gain was observed in 10 (14%) chemotherapy-naive and 33 (34%) post-docetaxel patients and associated with worse OS [hazard ratio (HR), 3.98; 95% CI 1.74-9.10; P<0.001 and HR 3.81; 95% CI 2.28-6.37; P<0.001, respectively], PFS (HR 2.18; 95% CI 1.08-4.39; P = 0.03, and HR 1.95; 95% CI 1.23-3.11; P = 0.01, respectively) and rate of PSA decline >= 50% [odds ratio (OR), 4.7; 95% CI 1.17-19.17; P = 0.035 and OR, 5.0; 95% CI 1.70-14.91; P = 0.003, respectively]. ARmutations [2105T>A (p.L702H) and 2632A>G (p.T878A)] were observed in eight (11%) post-docetaxel but no chemotherapy-naive abiraterone-treated patients and were also associated with worse OS (HR 3.26; 95% CI 1.47-not reached; P = 0.004). There was no interaction between AR and docetaxel status (P = 0.83 for OS, P = 0.99 for PFS). In the PREMIERE trial, 11 patients (12%) with AR gain had worse PSA-PFS (sPFS) (HR 4.33; 95% CI 1.94-9.68; P<0.001), radiographic-PFS (rPFS) (HR 8.06; 95% CI 3.26-19.93; P<0.001) and OS (HR 11.08; 95% CI 2.16-56.95; P = 0.004). Plasma AR was an independent predictor of outcome on multivariable analyses in both cohorts. Conclusion: Plasma AR status assessment using ddPCR identifies CRPC with worse outcome to enzalutamide or abiraterone. Prospective evaluation of treatment decisions based on plasma AR is now required. Clinical Trial number: NCT02288936 (PREMIERE trial).enghttp://creativecommons.org/licenses/by/4.0/Castration-resistant prostate cancerAndrogen receptorPlasma DNAEnzalutamideAbirateroneBiomarkerDisease-Free Survivalresearch articleAttribution 4.0 International284723662871508-151610.1093/annonc/mdx1551569-8041Annals of Oncologyopen accessAntineoplásicos HormonalesSelección de PacienteModelos de Riesgos ProporcionalesResultado del TratamientoOportunidad RelativaEuropa (Continente)Análisis Mutacional de ADNMasculinoReceptores AndrogénicosPersona de Mediana EdadEstudios ProspectivosEstimación de Kaplan-MeierProgresión de la EnfermedadMedicina de PrecisiónAndrostenosSupervivencia sin EnfermedadFactores de TiempoAnálisis MultivarianteNeoplasias de la Próstata Resistentes a la CastraciónReacción en Cadena de la Polimerasa MultiplexBiomarcadores de TumorMutaciónFeniltiohidanto�naFactores de RiesgoHumanosValor Predictivo de las PruebasAncianoAnciano de 80 o más AñosAdultoADN Tumoral Circulante2-s2.0-85019315640404134100016L619392989