Clinical and genomic analysis of metastatic prostate cancer progression with a background of postoperative biochemical recurrence.

Abstract

OBJECTIVE:

To better characterize the genomics of patients with biochemical recurrence (BCR) who have metastatic disease progression in order to improve treatment decisions for prostate cancer.

METHODS:

The expression profiles of three clinical outcome groups after radical prostatectomy (RP) were compared: those with no evidence of disease (NED; n = 108); those with BCR (rise in prostate-specific antigen [PSA] level without metastasis; n = 163); and those with metastasis (n = 192). The patients were profiled using Human Exon 1.0 ST microarrays, and outcomes were supported by a median 18 years of follow-up. A metastasis signature was defined and verified in an independent RP cohort to ensure the robustness of the signature. Furthermore, bioinformatics characterization of the signature was conducted to decipher its biology.

RESULTS:

Minimal gene expression differences were observed between adjuvant treatment-naïve patients in the NED group and patients without metastasis in the BCR group. More than 95% of the differentially expressed genes (metastasis signature) were found in comparisons between primary tumours of metastasis patients and the two other outcome groups. The metastasis signature was validated in an independent cohort and was significantly associated with cell cycle genes, ubiquitin-mediated proteolysis, DNA repair, androgen, G-protein coupled and NOTCH signal transduction pathways.

CONCLUSION:

This study shows that metastasis development after BCR is associated with a distinct transcriptional programme that can be detected in the primary tumour. Patients with NED and BCR have highly similar transcriptional profiles, suggesting that measurement of PSA on its own is a poor surrogate for lethal disease. Use of genomic testing in patients undergoing RP with an initial rise in PSA level may be useful to improve secondary therapy decision-making.

• Authors: Mohammed Alshalalfa, Anamaria Crisan, Ismael A Vergara, Mercedeh Ghadessi, Christine Buerki, Nicholas Erho, Kasra Yousefi, Thomas Sierocinski, Zaid Haddad, Peter C Black, R Jeffrey Karnes, Robert B Jenkins, Elai Davicioni
• Journal: BJU international (BJU Int) Vol. 116 Issue 4 Pg. 556-67 (Oct 2015) ISSN: 1464-410X [Electronic] England
• PMID: 25762434 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: © 2014 The Authors BJU International © 2014 BJU International Published by John Wiley & Sons Ltd.

Chemical References

• RNA, Untranslated
• Prostate-Specific Antigen

Topics

• Case-Control Studies
• Disease Progression
• Gene Expression Profiling
• Humans
• Male
• Neoplasm Recurrence, Local (blood, epidemiology, genetics, pathology)
• Postoperative Period
• Prostate-Specific Antigen (blood)
• Prostatic Neoplasms (epidemiology, genetics, metabolism, pathology)
• Protein Interaction Maps (genetics)
• RNA, Untranslated (genetics)
• Transcriptome (genetics)