Prostate Specific Membrane Antigen mRNA in Blood as a Potential Predictor of Biochemical Recurrence after Radical Prostatectomy

Abstract

We investigated whether the detection of prostate specific membrane antigen (PSMA) in blood preoperatively has predictive value for biochemical recurrence (BCR) after radical prostatectomy in patients with prostate cancer. All 134 patients scheduled to receive radical prostatectomy for prostate cancer were prospectively enrolled. The authors used nested reverse transcriptase-polymerase chain reaction (RT-PCR) assay to detect PSMA mRNA-bearing cells in peripheral blood, and analyzed the ability of PSMA mRNA positivity to predict BCR after surgery. PSMA-mRNA was detected in 24 (17.9%) patients by RT-PCR. Over a median follow-up of 20 months (range, 3 to 46 months), BCR developed in 15 patients (11.2%) and median time to BCR was 7 months (range, 3 to 25 months). Kaplan-Meier analysis revealed a significant difference between those positive or negative for PSMA in terms of recurrence-free actuarial probability (log rank P=0.0039). Multivariate analysis showed that positivity for PSMA mRNA (HR: 3.697, 95% CI 1.285-10.634, P=0.015) and a biopsy Gleason score of ≥7 (HR: 4.500, 95% CI 1.419-14.274, P=0.011) were independent preoperative predictors of BCR. The presence of PSMA mRNA in peripheral blood can be used to predict BCR after radical prostatectomy.

Analysis of AR/ARV7 Expression in Isolated Circulating Tumor Cells of Patients with Metastatic Castration-Resistant Prostate Cancer (SAKK 08/14 IMPROVE Trial)

“…PSMA is known to be over-expressed in advanced PC or mCRPC [33]. While strong PSMA expression in the tumor has been associated with higher tumor stages, Gleason Scores, preoperative PSA levels, HER2 expression, and a higher risk of biochemical recurrence [34], there is no correlation between blood PSMA mRNA and tumor stage, Gleason score, or serum PSA [35]. However, it has been shown that the detection of the PSMA mRNA in blood can predict biochemical recurrence after radical prostatectomy [35].…”

“…While strong PSMA expression in the tumor has been associated with higher tumor stages, Gleason Scores, preoperative PSA levels, HER2 expression, and a higher risk of biochemical recurrence [34], there is no correlation between blood PSMA mRNA and tumor stage, Gleason score, or serum PSA [35]. However, it has been shown that the detection of the PSMA mRNA in blood can predict biochemical recurrence after radical prostatectomy [35]. Furthermore, PSMA expression in CTCs is characterized by a high intra-patient heterogeneity and is found in a large portion (67%) of metastatic PC patients by the CellSearch ® assay [36].…”

Molecular pathology of prostate cancer: a practical approach

“…7). 86,87 Only recently, PSMA-targeted therapies labelled with beta emitters like Lutetium-177 ( 177 Lu) for radioligand therapy have emerged as a promising therapeutic option for patients with mCRPC. 88,89 Patients are screened for eligibility according to high PSMA uptake in the metastases as detected by 68 Ga-labelled PSMA-positron emission tomography ( 68 Ga-PSMA-PET).…”

Establishment and Application of Prostate Cancer Circulating Tumor Cells in the Era of Precision Medicine

“…In the study with 250 high-risk patients with PC, presence of prostate stem cell antigen (PSCA) mRNA in the peripheral blood was reported to be a significant predictor of biochemical recurrence after radical prostatectomy (HR, 4.549; 95% CI, 1.685–12.279) [ 93 ]. Joung et al reported that prostate specific membrane antigen (PSMA) mRNA in the peripheral blood was a predictor of biochemical recurrence after radical prostatectomy [ 95 ]. Nested RT-PCR assay detecting PSMA mRNA-bearing cells in the peripheral blood was employed to detect CTCs.…”