Circulating tumor DNA profile recognizes transformation to castration-resistant neuroendocrine prostate cancer.

TitleCirculating tumor DNA profile recognizes transformation to castration-resistant neuroendocrine prostate cancer.
Publication TypeJournal Article
Year of Publication2020
AuthorsBeltran H, Romanel A, Conteduca V, Casiraghi N, Sigouros M, Franceschini GMarco, Orlando F, Fedrizzi T, Ku S-Y, Dann E, Alonso A, Mosquera JMiguel, Sboner A, Xiang J, Elemento O, Nanus DM, Tagawa ST, Benelli M, Demichelis F
JournalJ Clin Invest
Date Published2020 Apr 01

Loss of androgen receptor (AR) signaling dependence occurs in approximately 15%-20% of advanced treatment-resistant prostate cancers, and this may manifest clinically as transformation from a prostate adenocarcinoma histology to a castration-resistant neuroendocrine prostate cancer (CRPC-NE). The diagnosis of CRPC-NE currently relies on a metastatic tumor biopsy, which is invasive for patients and sometimes challenging to diagnose due to morphologic heterogeneity. By studying whole-exome sequencing and whole-genome bisulfite sequencing of cell free DNA (cfDNA) and of matched metastatic tumor biopsies from patients with metastatic prostate adenocarcinoma and CRPC-NE, we identified CRPC-NE features detectable in the circulation. Overall, there was markedly higher concordance between cfDNA and biopsy tissue genomic alterations in patients with CRPC-NE compared with castration-resistant adenocarcinoma, supporting greater intraindividual genomic consistency across metastases. Allele-specific copy number and serial sampling analyses allowed for the detection and tracking of clonal and subclonal tumor cell populations. cfDNA methylation was indicative of circulating tumor content fraction, reflective of methylation patterns observed in biopsy tissues, and was capable of detecting CRPC-NE-associated epigenetic changes (e.g., hypermethylation of ASXL3 and SPDEF; hypomethylation of INSM1 and CDH2). A targeted set combining genomic (TP53, RB1, CYLD, AR) and epigenomic (hypo- and hypermethylation of 20 differential sites) alterations applied to ctDNA was capable of identifying patients with CRPC-NE.

Alternate JournalJ. Clin. Invest.
PubMed ID32091413
PubMed Central IDPMC7108892
Grant ListP50 CA211024 / CA / NCI NIH HHS / United States