1. Molecular Profiling to Determine Clonality of Serial Magnetic Resonance Imaging/Ultrasound Fusion Biopsies from Men on Active Surveillance for Low-Risk Prostate Cancer
- Author
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Palapattu, Ganesh S, Salami, Simpa S, Cani, Andi K, Hovelson, Daniel H, de la Vega, Lorena Lazo, Vandenberg, Kelly R, Bratley, Jarred V, Liu, Chia-Jen, Kunju, Lakshmi P, Montgomery, Jeffery S, Morgan, Todd M, Natarajan, Shyam, Huang, Jiaoti, Tomlins, Scott A, and Marks, Leonard S
- Subjects
Biomedical and Clinical Sciences ,Clinical Sciences ,Oncology and Carcinogenesis ,Genetics ,Prostate Cancer ,Urologic Diseases ,Clinical Research ,Cancer ,Biomedical Imaging ,Aging ,Biotechnology ,Aetiology ,Detection ,screening and diagnosis ,2.1 Biological and endogenous factors ,4.1 Discovery and preclinical testing of markers and technologies ,Good Health and Well Being ,Aged ,Biopsy ,Clonal Evolution ,High-Throughput Nucleotide Sequencing ,Humans ,Magnetic Resonance Imaging ,Male ,Middle Aged ,Mutation ,Neoplasm Grading ,Neoplasm Proteins ,Prostatic Neoplasms ,Ultrasonography ,Oncology & Carcinogenesis ,Clinical sciences ,Oncology and carcinogenesis - Abstract
Purpose: To determine whether MRI/ultrasound (MRI/US) fusion biopsy facilitates longitudinal resampling of the same clonal focus of prostate cancer and to determine whether high-grade cancers can evolve from low-grade clones.Experimental Design: All men on active surveillance who underwent tracking MRI/US fusion biopsy of Gleason 6 prostate cancer, on at least two distinct occasions, between 2012 and 2014 were enrolled. MRI/US fusion was used to track and resample specific cancer foci. IHC for ERG and targeted RNA/DNA next-generation sequencing (NGS) were performed on formalin-fixed paraffin-embedded prostate biopsy specimens to assess clonality.Results: Thirty-one men with median age and PSA of 65 years and 4.6 ng/mL, respectively, were analyzed. The median sampling interval was 12 months (range, 5-35). Of the 26 evaluable men, ERG IHC concordance was found between initial and repeat biopsies in 25 (96%), indicating resampling of the same clonal focus over time. Targeted NGS supported ERG IHC results and identified unique and shared driving mutations, such as IDH1 and SPOP, in paired specimens. Of the nine men (34.6%) who were found to have Gleason ≥7 on repeat biopsy, all displayed temporal ERG concordance. Prioritized genetic alterations were detected in 50% (13/26) of paired samples. Oncogenic mutations were detected in 22% (2/9) of Gleason 6 cancers prior to progression and 44% (4/9) of Gleason ≥7 cancers when progression occurred.Conclusions: Precise tracking of prostate cancer foci via MRI/US fusion biopsy allowed subsequent resampling of the same clonal focus of cancer over time. Further research is needed to clarify the grade progression potential of Gleason 6 prostate cancer. Clin Cancer Res; 23(4); 985-91. ©2016 AACR.
- Published
- 2017