Beltran Himisha, Prandi Davide, Mosquera Juan Miguel, Benelli Matteo, Puca Loredana, Cyrta Joanna, Marotz Clarisse, Giannopoulou Eugenia, Chakravarthi Balabhadrapatruni V S K, Varambally Sooryanarayana, Tomlins Scott A, Nanus David M, Tagawa Scott T, Van Allen Eliezer M, Elemento Olivier, Sboner Andrea, Garraway Levi A, Rubin Mark A, Demichelis Francesca
Caryl and Israel Englander Institute for Precision Medicine, New York Presbyterian Hospital-Weill Cornell Medicine, New York, New York, USA.
Department of Medicine, Division of Hematology and Medical Oncology, Weill Cornell Medicine, New York, New York, USA.
Nat Med. 2016 Mar;22(3):298-305. doi: 10.1038/nm.4045. Epub 2016 Feb 8.
An increasingly recognized resistance mechanism to androgen receptor (AR)-directed therapy in prostate cancer involves epithelial plasticity, in which tumor cells demonstrate low to absent AR expression and often have neuroendocrine features. The etiology and molecular basis for this 'alternative' treatment-resistant cell state remain incompletely understood. Here, by analyzing whole-exome sequencing data of metastatic biopsies from patients, we observed substantial genomic overlap between castration-resistant tumors that were histologically characterized as prostate adenocarcinomas (CRPC-Adeno) and neuroendocrine prostate cancer (CRPC-NE); analysis of biopsy samples from the same individuals over time points to a model most consistent with divergent clonal evolution. Genome-wide DNA methylation analysis revealed marked epigenetic differences between CRPC-NE tumors and CRPC-Adeno, and also designated samples of CRPC-Adeno with clinical features of AR independence as CRPC-NE, suggesting that epigenetic modifiers may play a role in the induction and/or maintenance of this treatment-resistant state. This study supports the emergence of an alternative, 'AR-indifferent' cell state through divergent clonal evolution as a mechanism of treatment resistance in advanced prostate cancer.
前列腺癌中一种越来越被认可的针对雄激素受体(AR)靶向治疗的耐药机制涉及上皮可塑性,即肿瘤细胞表现出低水平至无AR表达,且通常具有神经内分泌特征。这种“另类”的治疗抵抗细胞状态的病因和分子基础仍未完全明确。在此,通过分析患者转移性活检样本的全外显子测序数据,我们观察到组织学上被归类为前列腺腺癌的去势抵抗性肿瘤(CRPC-Adeno)和神经内分泌前列腺癌(CRPC-NE)之间存在大量基因组重叠;对同一患者不同时间点活检样本的分析表明,最符合的模型是克隆进化分歧。全基因组DNA甲基化分析揭示了CRPC-NE肿瘤与CRPC-Adeno之间存在明显的表观遗传差异,并且还将具有AR非依赖性临床特征的CRPC-Adeno样本归类为CRPC-NE,这表明表观遗传修饰因子可能在这种治疗抵抗状态的诱导和/或维持中发挥作用。本研究支持通过克隆进化分歧出现一种另类的“AR不敏感”细胞状态,作为晚期前列腺癌治疗抵抗的一种机制。
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