Prostate cancer: Multifocal disease—independent clonal lineages in malignant nodules and even in normal tissue

Abstract

Multifocal disease—independent clonal lineages in malignant nodules and even in normal tissue DNA-sequencing studies of samples from prostates with multifocal cancer lesions demonstrate that morphologically normal tissues can carry mutations similar to those in distant tumour nodules. In addition, a single cancer nodule can harbour different clonal lineages. Heterogeneity of mutations between nodules points towards independent development of malignant lesions within the same prostate. These data, recently published in Nature Genetics, shed light on the origin of multifocal prostate cancer and raise important questions about optimal treatment strategies. Many men who are diagnosed with prostate cancer have multifocal disease, which complicates accurate staging and treatment planning. Importantly, it was unclear whether different tumour nodules share the same mutational heritage or whether they result from independent clonal expansions. At a time when targeted agents become promising treatments for some cancer types and novel prostate cancer biomarkers are urgently needed, answering such questions about tumour heterogeneity in prostate cancer is key to enabling successful therapy. The study was carried out by an international collaborative group, which performs next-generation DNA sequencing of prostate cancer genomes and is part of the International Cancer Genome Consortium. “As one of the early experiments, we decided to decode the genetic phylogeny of multifocal prostate cancer in a small number of men,” explains David Neal from the University of Cambridge, UK, one of the principal investigators of the study. “We decided to also examine apparently benign areas of the prostate that are distant from the cancers themselves.”

DOI: 10.1038/nrurol.2015.52

Cite this paper

@article{Thoma2015ProstateCM, title={Prostate cancer: Multifocal disease—independent clonal lineages in malignant nodules and even in normal tissue}, author={Clemens Thoma}, journal={Nature Reviews Urology}, year={2015}, volume={12}, pages={177-177} }