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Highlights • The rolling b-allele method applied into a clinical assay allows detection of plasma tumor DNA independent of mutation calls. • Patients with TP53, RB1 or PTEN alterations persisting after one cycle treatment have the worst outcomes. • Conversion of alterations after one cycle is associated with the similar outcomes as patients negative before treatment. • Plasma AR gain pre-treatment persists at progression whilst AR point mutations appear de novo in ∼16%.
The COU-AA-302 and PREVAIL trials of abiraterone–prednisone and enzalutamide, respectively, confirmed the efficacy of potent androgen receptor (AR) targeting when compared with placebo in asymptomatic chemotherapy-naive men with metastatic castration-resistant prostate cancer (mCRPC) [1, 2]. The COU-AA-301 and AFFIRM trials confirmed efficacy in symptomatic men who had previously received docetaxel [3, 4].
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