A key player in the course of prostate cancer and a possible biomarker for metastatic castration-resistant prostate cancer (mCRPC) is aldo-keto reductase family 1 member C3 (AKR1C3). The majority of AKR1C3 research to date has been done using tissue samples. Therefore, researchers investigated the prognostic and predictive utility of AKR1C3 in patients with mCRPC for a study utilizing plasma-based liquid biopsy.

Sixty-two individuals with mCRPC were prospectively recruited. When mCRPC was diagnosed, all patients had multiple prostate biopsies. Immunohistochemistry (IHC) staining was utilized to find protein expression of AKR1C3 in the tissues. In order to gauge the expression levels of AKR1C3 in the exosomes, they concurrently drew their blood and ran a digital droplet polymerase chain reaction (ddPCR). In progression-free survival under first-line abiraterone use (ABI-PFS), the identified plasma and tissue AKR1C3 expression levels were examined for patient overall survival (OS).

The 2 groups were evenly distributed in terms of all other baseline characteristics. 25/62 (40.3%) and 15/62 (24.2%) of the patients, respectively, displayed positive results for AKR1C3-EXO (≥20 copies/20 μL) and AKR1C3-IHC. Patients with higher levels of AKR1C3-EXO expression had shorter median survival times[ABI-PFS: 3.9 vs. 10.1 months, P<0.001; OS: 16.2 vs. 32.5 months, P<0.001]. ABI-PFS and OS were linked (P=0.010, P=0.016) with AKR1C3-IHC positive. When AKR1C3-EXO was positive, OS was substantially poorer in patients with worse baseline blood tests, such as greater alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) levels and lower hemoglobin (HB) levels and worse ISUP/WHO group (<4).

AKR1C3-EXO can be employed as a biomarker in mCRPC and was related to patient prognosis for OS and ABI-PFS.

Reference: annalsofoncology.org/article/S0923-7534(22)01969-X/fulltext