This afternoon I am off to the American Society for Clinical Oncology Genitourinary Cancers Symposium (ASCO GU) in San Francisco. There has already been some information leaking to the media about some of the presentations that will be going on at the conference.

One such “leak” is about  findings from Memorial Sloan Kettering Cancer Center and Epic Sciences who will be reporting that they have found that greater diversity among circulating tumor cells (CTCs) in the blood (heterogeneity) of men with advanced prostate cancer predicts not only shorter overall survival, but also the development of resistance to anti-androgen therapies. However, the same high diversity among CTCs was not associated with resistance to taxane chemotherapy.  This suggests that men who are likely to fail anti-androgen therapies can still potentially benefit from chemotherapy.

According to Howard Scher, M.D., who led the study and is the Chief of the Genitourinary Oncology Service at Memorial Sloan Kettering Cancer Center “Heterogeneity is the next frontier for oncology. Quantifying heterogeneity and understanding how it affects the sensitivity to specific classes of drug will enable the choice of one treatment over another to be based on the unique features of individual patients’ disease and has significant implications for the development of new drugs.”

Murali Prahalad, Ph.D., President and CEO of Epic Sciences said that, “Highly heterogeneous cancers are tougher to beat…heterogeneous cancers have a diversity of cell populations, each with distinct genomic variations, cellular morphologies, and protein expression. Since the populations of tumor cells are so different, it’s more likely that a single therapy can only treat a small part of the cancer and that highly aggressive CTC species remain to drive disease progression.”

There will come a time when we all will have access to blood tests that sort out CTCs, but until then all we can do is learn about them, that is unless you find a clinical trial involving CTCs.