Tracking the origins and drivers of subclonal metastatic expansion in prostate cancer.

Nat Commun

1] Department of Surgery, Division of Urology, Royal Melbourne Hospital and University of Melbourne, Parkville 3050, Victoria, Australia [2] The Epworth Prostate Centre, Epworth Hospital, Richmond 3121, Victoria, Australia.

Published: April 2015

AI Article Synopsis

  • Tumour heterogeneity in primary prostate cancer is well-known, but how this diversity changes during metastasis and progression is not fully understood.
  • Researchers studied four patients with lethal prostate cancer using advanced sequencing techniques on primary and metastatic tumours to track their spread.
  • They found instances of local recurrence and the dynamic adaptation of tumour subclones in response to treatment, discovering that TP53 mutations are associated with increased metastatic potential that can be detected in the blood years after prostate removal.

Article Abstract

Tumour heterogeneity in primary prostate cancer is a well-established phenomenon. However, how the subclonal diversity of tumours changes during metastasis and progression to lethality is poorly understood. Here we reveal the precise direction of metastatic spread across four lethal prostate cancer patients using whole-genome and ultra-deep targeted sequencing of longitudinally collected primary and metastatic tumours. We find one case of metastatic spread to the surgical bed causing local recurrence, and another case of cross-metastatic site seeding combining with dynamic remoulding of subclonal mixtures in response to therapy. By ultra-deep sequencing end-stage blood, we detect both metastatic and primary tumour clones, even years after removal of the prostate. Analysis of mutations associated with metastasis reveals an enrichment of TP53 mutations, and additional sequencing of metastases from 19 patients demonstrates that acquisition of TP53 mutations is linked with the expansion of subclones with metastatic potential which we can detect in the blood.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4396364PMC
http://dx.doi.org/10.1038/ncomms7605DOI Listing

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