Androgen Receptor Splice Variant 7 Predicts Shorter Response in Patients with Metastatic Hormone-sensitive Prostate Cancer Receiving Androgen Deprivation Therapy

Background: Whether AR-V7 expression can predict the response in patients with metastatic hormone-sensitive prostate cancer (mHSPC) who receive androgen deprivation therapy (ADT) remains to be explored. Objective: To evaluate the predictive value of AR-V7 expression in the prognosis of mHSPC patients receiving ADT. Design, setting, and participants: In this multicenter prospective cohort study, 310 mHSPC patients commencing ADT were enrolled. Standard immunohistochemical staining was used to assess AR-V7 protein expression in biopsy tissues collected before initiation of ADT. Outcome measurements and statistical analysis: Kaplan-Meier survival estimates and Cox regression analyses were used to evaluate associations of AR-V7 status (positive vs negative) with progression-free survival (PFS) and overall survival (OS). Results and limitations: Sixty-four (21%) patients were AR-V7-positive and 246 (79%) patients were AR-V7-negative. The median follow-up for patients not confirmed dead was 25 mo (interquartile range 10-30). Compared to AR-V7-negative patients, AR-V7-positive patients had significantly shorter PFS (hazard ratio [HR] 47.39, 95% confidence interval [CI] 25.83-86.94) and OS (HR 3.57, 95% CI 1.46-8.72). In multivariable analysis, AR-V7 was an independent predictive factor (HR 7.61, 95% CI 5.24-11.06) for shorter PFS. Limitations include the sample size and follow-up period. Conclusions: AR-V7 expression in primary cancer tissue is correlated with poor prognosis for mHSPC patients receiving ADT. Patient summary: In this study of men with metastatic hormone-sensitive prostate cancer, AR-V7 protein expression in primary cancer tissue was associated with poor outcomes on androgen deprivation therapy. (C) 2021 European Association of Urology. Published by Elsevier B.V. All rights reserved.

Automated summary

AR-V7 expression in primary cancer tissue is correlated with poor prognosis for mHSPC patients receiving ADT. AR-V7-positive patients had significantly shorter PFS and OS compared to AR-V7-negative patients, indicating that AR-V7 is an independent predictive factor for shorter PFS. Limitations include sample size and follow-up period.