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Metastatic, castration-resistant prostate cancer (mCRPC) may exhibit varied clinical courses. Some mCRPC patients will develop metastasis beyond the bone and lymph nodes, including theliver, lungs, and adrenal glands. These conditions are termed visceral metastases (VM).Patients with VM have significantly poorer overall survival than patients with non-VM, as their clinical course involves rapid deterioration from organ failure. Certain CRPC treatments have been shown to push the progression of the cancer to its more aggressive VMform. This highlights the importance of developing a means of detecting and predicting cancer progression to the viscera. Using the NanoVelcro Chip designed to capture circulating tumor cells (CTCs), we identified a morphologically unique subgroup of these cells, which we termed very-small-nuclear CTCs (vsnCTCs). We found that these vsnCTCs appear in patients with VM and begin emerging before the disease progresses to VM. Thus we hypothesize that vsnCTCs are associated with the development of VM and are biologically distinct from non-vsnCTCs, which lead to a different clinical course. We aim to analyze the association between vsnCTCs and VM, as these cells could play a key role in detection VM. Additionally, we aim to compare the gene expression of vsnCTCs and non-vsnCTCs to gain greater insight into the biology of VM.