Andrew J. Armstrong, MD, discusses the rationale of the PROPHECY trial in metastatic castration-resistant prostate cancer.
Andrew J. Armstrong, MD, professor of medicine, associate professor in pharmacology and cancer biology, and professor in surgery at Duke University School of Medicine and a member of the Duke Cancer Institute, discusses the rationale of the PROPHECY trial in metastatic castration-resistant prostate cancer (mCRPC).
The purpose of the PROPHECY study was to develop a molecular taxonomy of prostate cancer using liquid biopsies with a primary objective of validating AR-V7 as a predictive biomarker for treating men with metastatic CRPC with abiraterone acetate (Zytiga) or enzalutamide (Xtandi), explains Armstrong. This study was granted the Prostate Cancer Foundation Global Challenge Award and required 5 centers, as well as 5 central labs, to conduct the research.
The results were published in 2019 in the Journal of Clinical Oncology, which established AR-V7 as a negative predictive biomarker for response to abiraterone or enzalutamide. The biopsies were conducted using the Johns Hopkins University modified-AdnaTest CTC AR-V7 mRNA assay and the Epic Sciences CTC nuclear-specific AR-V7 protein assay. Both assays were associated with low possibility of prostate-specific antigen response, and objective response as well as short progression-free survival and overall survival in a multivaried analysis, concludes Armstrong.