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Practical Recommendations for Circulating Tumor Cells in Prostate Cancer

Interview with Tanya Dorff MD

‘Filmed by PracticeUpdate with permission for inclusion on Uro Onco. More information and additional ASCO coverage can be found at www.practiceupdate.com

‘Interview transcript’

Dr. Haffizulla: Welcome to PracticeUpdate. I'm Dr. Farzanna Haffizulla. Joining me today is Dr. Tanya Dorff. Dr Dorff is an Assistant Professor of Clinical Medicine at USC Norris Comprehensive Cancer Center and Hospital at the University of Southern California. Dr. Dorff, excited to have you back.

Dr. Dorff: Thanks for having me.

Dr. Haffizulla: So, we wanted to focus on circulating tumor cells in advanced prostate cancer. Can you review some of the evidence presented at ASCO?

Dr. Dorff: So, we've known over the years that enumeration of circulating tumor cells using the CellSearch Viradex assay is a strong prognostic indicator for prostate cancer independent of PSA. However, what's new at the meeting is the more advanced technologies that are not only enumerating circulating tumor cells but actually looking at characteristics of them and how that relates to treatment effect.

Dr. Haffizulla: Well, how do circulating tumor cells apply in your particular clinical practice, if at all?

Dr. Dorff: So, in a disease where bone metastases are predominant and PSA isn't always giving us the full story, we really need another indicator whether patients are benefitting from treatment, so I used to use circulating tumor cells in that context. For instance, someone whose PSA wasn't really changing, bone scan wasn't changing, knowing whether the CTCs were favorable or unfavorable could really give me a sense of whether they were benefitting from treatment. Unfortunately, the assay's not reimbursed, so I haven't been able to use it in day-to-day practice. What's lacking is a trial that shows prospectively that switching treatment on the basis of the CTC count improves outcomes.

Dr. Haffizulla: That's an important point to highlight and maybe a clinical trial can be designed to meet that deficit in information. We want to thank you again for joining us on Practice Update, Dr. Dorff, and we are looking forward to hearing more from you soon.

Dr. Dorff: Thanks. Have a good day.

Dr. Haffizulla: Absolutely. To our viewers, thank you again for joining us for this PracticeUpdate. I'm Dr. Farzanna Haffizulla.