Structural Alterations Driving Castration-Resistant Prostate Cancer Revealed by Linked-Read Genome Sequencing

Cell. 2018 Jul 12;174(2):433-447.e19. doi: 10.1016/j.cell.2018.05.036. Epub 2018 Jun 18.

Abstract

Nearly all prostate cancer deaths are from metastatic castration-resistant prostate cancer (mCRPC), but there have been few whole-genome sequencing (WGS) studies of this disease state. We performed linked-read WGS on 23 mCRPC biopsy specimens and analyzed cell-free DNA sequencing data from 86 patients with mCRPC. In addition to frequent rearrangements affecting known prostate cancer genes, we observed complex rearrangements of the AR locus in most cases. Unexpectedly, these rearrangements include highly recurrent tandem duplications involving an upstream enhancer of AR in 70%-87% of cases compared with <2% of primary prostate cancers. A subset of cases displayed AR or MYC enhancer duplication in the context of a genome-wide tandem duplicator phenotype associated with CDK12 inactivation. Our findings highlight the complex genomic structure of mCRPC, nominate alterations that may inform prostate cancer treatment, and suggest that additional recurrent events in the non-coding mCRPC genome remain to be discovered.

Keywords: CDK12; MYC; androgen receptor; castration-resistant prostate cancer; cell-free DNA; enhancer; linked read whole-genome sequencing; non-coding cancer genome; structural variants; tandem duplicator phenotype.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Anilides / therapeutic use
  • Cyclin-Dependent Kinases / genetics
  • Cyclin-Dependent Kinases / metabolism
  • Enhancer Elements, Genetic / genetics
  • Gene Duplication
  • Gene Rearrangement
  • Genes, myc
  • Genetic Loci
  • Haplotypes
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • PTEN Phosphohydrolase / genetics
  • Phenotype
  • Prostate-Specific Antigen / blood
  • Prostatic Neoplasms, Castration-Resistant / drug therapy
  • Prostatic Neoplasms, Castration-Resistant / genetics
  • Prostatic Neoplasms, Castration-Resistant / pathology*
  • Protein Kinase Inhibitors / therapeutic use
  • Pyridines / therapeutic use
  • Receptors, Androgen / genetics*
  • Whole Genome Sequencing*

Substances

  • Anilides
  • Protein Kinase Inhibitors
  • Pyridines
  • Receptors, Androgen
  • cabozantinib
  • CDK12 protein, human
  • Cyclin-Dependent Kinases
  • PTEN Phosphohydrolase
  • PTEN protein, human
  • Prostate-Specific Antigen