IdISSC Research Seminar – May’23

3 May 2023


Identification of biological factors associated with early metastatic progression in patients with M0 castration-resistant prostate cancer with elevated PSA

Dr. Javier Puente Vázquez

GU Cancer Unit. Medical Oncology Department. Assistant Professor of Medicine, Complutense University. Clinical and Translational Research in Oncology Research Group Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC).


Despite the efficacy of radical treatment, up to 20-30% of these patients treated for localised prostate cancer will suffer biochemical recurrence and, consequently, a large proportion of patients will be receiving androgen deprivation therapy (ADT) in the absence of any detectable metastases, and since such ADT will not be curative when used in isolation, a proportion of these patients will progress and become castration resistant (CRPC). Although CRPC can be defined by biochemical progression, radiological and/or clinical progression, with testosterone levels in the castration range, most CRPC cases are reported as PSA progression in the absence of any detectable metastases. To some extent, this introduces a bias in our perception of the disease. Indeed, an increase in PSA is almost pathognomonic of androgen receptor (AR) reactivation. However, other progression pathways independent of AR reactivation may occur and therefore would not be associated with PSA progression. The behaviour of this group of patients (called CPRC M0 “PSA rising”) is highly variable, and it is necessary to know which alterations predict a more aggressive biological behaviour, in order to require earlier therapeutic intervention or not. The aim of this project was to analyse this subgroup of patients by identifying potential biomarkers centred on the androgen receptor that stratify the risk of these patients in the development of metastasis.

Bibliographic reference

  • Hussain M, Fizazi K, Saad F, Rathenborg P, Shore N, Ferreira U, et al. Enzalutamide in men with nonmetastatic, castration-resistant prostate cancer. N Engl J Med. 2018;378(26):2465–74.
  • Smith MR, Saad F, Chowdhury S, Oudard S, Hadaschik BA, Graff JN, et al. Apalutamide treatment and metastasis-free survival in prostate cancer. N Engl J Med 2018;378:1408–18.
  • Fizazi K, Shore N, Tammela TL, Ulys A, Vjaters E, Polyakov S, et al., Darolutamide in Nonmetastatic, Castration- Resistant Prostate Cancer. N Engl J Med 2019; 380(13): 1235-1246.

13:30 h

CSF ctDNA detection and concordance with the primary tumour in patients with gliomas: results of a prospective, multicentre study.

Dr. Santiago Cabezas Camarero

Head and Neck Tumours, Neuro-Oncology and Hereditary Cancer Unit Medical Oncology Service HCSC. Clinical and Translational Research Group in Oncology Health Research Institute of the Hospital Clínico San Carlos (IdISSC).


Gliomas are the most common primary brain tumours, but there are currently many limitations to the application of liquid biopsy in this entity. Cerebrospinal fluid (CSF) is emerging as the most cost-effective reservoir for ctDNA analysis in primary CNS tumours, although evidence is still limited.

Bibliographic reference

  • Juratli, et al. Clin Cancer Res 2018;24:5282;
  • Martínez-Ricarte, et al. Clin Cancer Res 2018;24:2812-19; 
  • Miller, et al. Nature 2019;565:654-8.    

Virtual mode:

Classroom: Aula Fernández-Cruz of the teaching pavilion of the Hospital Clínico San Carlos.

Contact e-mail address: