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

Nat Commun. 2015 Apr 1;6:6605. doi: 10.1038/ncomms7605.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / genetics*
  • Adenocarcinoma / secondary
  • Aged
  • Bone Neoplasms / genetics*
  • Bone Neoplasms / secondary
  • Brain Neoplasms / genetics*
  • Brain Neoplasms / secondary
  • DNA Copy Number Variations
  • Disease Progression
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Mutation
  • Neoplasm Metastasis
  • Polymorphism, Single Nucleotide
  • Prostatic Neoplasms / genetics*
  • Prostatic Neoplasms / pathology
  • RNA, Messenger
  • Sequence Analysis, DNA
  • Tumor Suppressor Protein p53 / genetics*

Substances

  • RNA, Messenger
  • TP53 protein, human
  • Tumor Suppressor Protein p53

Associated data

  • SRA/EGAS00001000942