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Poster session 01

86P - Plasma exosomal AKR1C3 mRNA expression is a predictive and prognostic biomarker in metastatic castration-resistant prostate cancer patients


10 Sep 2022


Poster session 01


Tumour Site

Prostate Cancer


Sha Zhu


Annals of Oncology (2022) 33 (suppl_7): S27-S54. 10.1016/annonc/annonc1037


S. Zhu1, Y. Ni2, G. Sun3, H. Zeng1

Author affiliations

  • 1 Urology, West China Hospital of Sichuan University, 610041 - Chengdu/CN
  • 2 Urology, West China School of Medicine/West China Hospital of Sichuan University, 610041 - Chengdu/CN
  • 3 Department Of Urology, West China Hospital of Sichuan University, 610041 - Chengdu/CN

Abstract 86P


Aldo-keto reductase family 1 member C3 (AKR1C3) is important in prostate cancer progression, being a potential biomarker in metastatic castration-resistant prostate cancer (mCRPC). Previous explorations of AKR1C3 are mainly based on tissue samples. This study investigates using plasma-based liquid biopsy to validate the prognostic and predictive value of AKR1C3 in mCRPC patients.


We prospectively recruited 62 mCRPC patients. All patients received repeated prostate biopsies at the time of mCRPC diagnosis, and immunohistochemistry (IHC) staining was used to detect protein expression of AKR1C3 in the tissues. We took their blood simultaneously and performed digital droplet polymerase chain reaction (ddPCR) to measure expression levels of AKR1C3 in the exosomes. The detected plasma and tissue AKR1C3 expression levels were analyzed for patients’ overall survival (OS) and progression-free survival under first-line abiraterone use (ABI-PFS).


All other baseline characteristics were balanced between the two groups. 15/62 (24.2%) and 25/62 (40.3%) patients showed AKR1C3-EXO positive (≥20 copies/20 μL) and AKR1C3-IHC positive, respectively. Positive AKR1C3-EXO expression was associated with decreased patients’ survival [ABI-PFS: 3.9 vs. 10.1 months, P<0.001; OS: 16.2 vs. 32.5 months, P<0.001]. AKR1C3-IHC positivity was also correlated with ABI-PFS and OS (P=0.010, P=0.016). In patients with worse baseline blood tests (including higher alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) level and lower hemoglobin (HB) level), and lower ISUP/WHO group (<4), their OS was significantly worse when showing AKR1C3-EXO positive.


AKR1C3-EXO is associated with patient prognosis regarding OS and ABI-PFS and can be used as a biomarker in mCRPC.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.


The Natural Science Foundation of China.


All authors have declared no conflicts of interest.

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