A systematic review of prostate cancer heterogeneity: understanding the clonal ancestry of multifocal disease
Bryant, R. J.
Hamdy, F. C.
Wedge, David C
Woodcock, D. J.
Mills, I. G.
Lamb, A. D.
AffiliationNuffield Department of Surgical Sciences, University of Oxford, Oxford
MetadataShow full item record
AbstractContext: Studies characterising genomic changes in prostate cancer (PCa) during natural progression have greatly increased our understanding of the disease. A better understanding of the evolutionary history of PCa would allow advances in diagnostics, prognostication, and novel therapies that together will improve patient outcomes. Objective: To review the molecular heterogeneity of PCa and assess recent efforts to profile intratumoural heterogeneity and clonal evolution. Evidence acquisition: We screened a total of 1313 abstracts from PubMed published between 2009 and 2020, of which we reviewed 84 full-text articles. We excluded 49, resulting in 35 studies for qualitative analysis. Evidence synthesis: In studies of primary disease (16 studies, 4793 specimens), there is a lack of consensus regarding the monoclonal or polyclonal origin of primary PCa. There is no consistent mutation giving rise to primary PCa. Detailed clonal analysis of primary PCa has been limited by current techniques. By contrast, clonal relationships between PCa metastases and a potentiating clone have been consistently identified (19 studies, 732 specimens). Metastatic specimens demonstrate consistent truncal genomic aberrations that suggest monoclonal metastatic progenitors. Conclusions: The relationship between the clonal dynamics of PCa and clinical outcomes needs further investigation. It is likely that this will provide a biological rationale for whether radical treatment of the primary tumour benefits patients with oligometastatic PCa. Future studies on the mutational burden in primary disease at single-cell resolution should permit the identification of clonal patterns underpinning the origin of lethal PCa. Patient summary: Prostate cancers arise in different parts of the prostate because of DNA mutations that occur by chance at different times. These cancer cells and their origin can be tracked by DNA mapping. In this review we summarise the state of the art and outline what further science is needed to provide the missing answers.
CitationErickson A, Hayes A, Rajakumar T, Verrill C, Bryant RJ, Hamdy FC, et al. A Systematic Review of Prostate Cancer Heterogeneity: Understanding the Clonal Ancestry of Multifocal Disease. European Urology Oncology. 2021 Apr
JournalEuropean Urology Oncology
- Spatial Intratumor Genomic Heterogeneity within Localized Prostate Cancer Revealed by Single-nucleus Sequencing.
- Authors: Su F, Zhang W, Zhang D, Zhang Y, Pang C, Huang Y, Wang M, Cui L, He L, Zhang J, Zou L, Zhang J, Li W, Li L, Shao J, Ma J, Xiao F, Liu M
- Issue date: 2018 Nov
- Novel Insights into the Management of Oligometastatic Prostate Cancer: A Comprehensive Review.
- Authors: Battaglia A, De Meerleer G, Tosco L, Moris L, Van den Broeck T, Devos G, Everaerts W, Joniau S
- Issue date: 2019 Mar
- The evolution of long noncoding RNA acceptance in prostate cancer initiation, progression, and its clinical utility in disease management.
- Authors: Ramnarine VR, Kobelev M, Gibb EA, Nouri M, Lin D, Wang Y, Buttyan R, Davicioni E, Zoubeidi A, Collins CC
- Issue date: 2019 Nov
- Genomic Evaluation of Multiparametric Magnetic Resonance Imaging-visible and -nonvisible Lesions in Clinically Localised Prostate Cancer.
- Authors: Parry MA, Srivastava S, Ali A, Cannistraci A, Antonello J, Barros-Silva JD, Ubertini V, Ramani V, Lau M, Shanks J, Nonaka D, Oliveira P, Hambrock T, Leong HS, Dhomen N, Miller C, Brady G, Dive C, Clarke NW, Marais R, Baena E
- Issue date: 2019 Feb
- More advantages in detecting bone and soft tissue metastases from prostate cancer using <sup>18</sup>F-PSMA PET/CT.
- Authors: Pianou NK, Stavrou PZ, Vlontzou E, Rondogianni P, Exarhos DN, Datseris IE
- Issue date: 2019 Jan-Apr