Purpose
The majority of prostate cancer mortality can be attributed to metastatic castration-resistant prostate cancer, an advanced stage which remains incurable despite recent advances. The androgen receptor (AR) signaling axis remains active in CRPC. Recent studies suggest that the expression of an AR splice variant, AR-V7, may underlie resistance to abiraterone and enzalutamide. However, controversy exists over the optimal assay. The objective of this study is to develop a fast and sensitive assay for AR splice variants (AR-Vs) in patients.
Materials and Methods
Two approaches were assessed in this study. The first was based on depletion of leukocytes and the second used RNA purified directly from whole blood preserved in PAXgene tubes. Transcript expression was analyzed by quantitative RT-PCR.
Results
Through side-by-side comparison, we concluded that the whole-blood approach was suitable for the detection of AR-Vs. The specificity of the assay was corroborated in a cancer-free cohort. Using the PAXgene assay, samples from a cohort of 46 CRPC patients were analyzed. Overall, AR-V7 and ARv567es were detected in 67.53% and 29.87% of the samples, respectively. Statistical analysis revealed a strong association of AR-V positivity with a history of second-line hormonal therapies.
Conclusions
To our knowledge, this study is the first to demonstrate PAXgene-preserved whole blood can be used to obtain clinically relevant information regarding the expression of two AR-Vs. The data from a CRPC cohort support a role of AR-Vs in resistance to therapies targeting the AR ligand-binding domain.
thromboembolic disease, we hypothesized that the number of ED patients with CVTs increased after the arrival of COVID-19 in the New York City area in early March 2020.Methods: Retrospective cohort design. EDs of 28 hospitals within 150 miles of New York City. Hospitals were teaching or non-teaching and rural, suburban or urban. Annual ED volumes were from 12,000 to 122,000. The database we had available included consecutive patients seen by ED physicians from March through November in 2019 and 2020. We tallied the number of patients diagnosed with CVTs using International Classification of Disease (version 10) codes.
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