Specific Aim. Prostate cancer (PCA) is a molecularly heterogeneous disease with a varied clinical spectrum ranging from indolent to highly aggressive. One late manifestation of PCA is progression to a neuroendocrine phenotype, which is universally lethal with an average survival of less than one year. It is estimated that 30% of late stage PCA transforms to neuroendocrine prostate cancer (NEPC), and potentially selected for or accelerated by the use of androgen deprivation therapies. With the introduction of more potent hormonal therapy into the clinical arena (e.g., Abiraterone, MDV3100), the incidence of NEPC is expected to escalate. We have generated preliminary data from Whole Genome DNA and RNA Sequencing leading us to hypothesize that NEPC arises from adenocarcinoma (AdCa) and that telltale molecular events determine a progression from hormone na?ve AdCa to lethal NEPC. Therefore, we propose 3 Specific Aims to elucidate the key molecular drivers of NEPC.
Specific Aim 1 : Define Somatic Copy Number Alterations Associated with the Emergence of NEPC. The working hypothesis of this Aim is that there are recurrent somatic copy number alterations (SCNA) associated with NEPC detectable prior to the development of neuroendocrine de-differentiation. At the conclusion of this Aim, we will nominate up to 20 genes from SCNA loci that are recurrent in NEPC and less common in AdCa with transcriptional support suggesting that these are gain of function (oncogenes) or loss of function (tumor suppressor) genes.
Specific Aim 2 : Determine Spectrum of Mutations Observed in NEPC. The working hypothesis of this Aim is that there are specific driving mutations that characterize NEPC. At the end of this Aim, we anticipate that a subset of these mutations and rearrangements contribute to neuroendocrine de-differentiation. We anticipate nominating up to 20 mutations that will be appropriate for further molecular functional evaluation.
Specific Aim 3 Determine the Functional Activity of NEPC Genes. The working hypothesis of this Aim is that alterations in a subset of the genes nominated in Aims 1-2 are gain or loss of function mutations. At the conclusion of this Aim we will have nominated up to 5 functionally active genes that are present in NEPC and a subset of AdCa. We will immediately follow up on these genes using xenograft models as part of another funded grant (no animal experiments are proposed in this application). We believe that the proposed studies will allow us new insight into a highly aggressive form of PCA.
Prostate Cancer is the most common non-cutaneous cancer and the second leading cause of cancer death in American men with over 31,000 estimated death in 2010. Neuroendocrine prostate cancer, the focus of this study, is a well-defined subtype of prostate cancer that is universally lethal with an average survival of less than one year. Neuroendocrine differentiation is most commonly found in advanced stage prostate cancer and after exposure to androgen deprivation therapy, and is associated with a poor clinical outcome. It is estimated that at least 30% of late stage prostate cancer transform to, and potentially selected for or accelerated by the use of androgen deprivation therapies. With the introduction of more potent hormonal therapy into the clinical arena (e.g., Abiraterone, MDV3100), the incidence of Neuroendocrine prostate cancer is expected to escalate. There is currently no effective therapy for NEPC, and many patients are treated with platinum based chemotherapy (similar to small cell lung cancer). Despite a reported response rate of 50-60% to chemotherapy, most patients with NEPC progress within 6 months and survive less than one year. Neuroendocrine prostate cancer is a highly understudied type of cancer. This is due to clinical practices that do not harvest advanced prostate cancer except under special circumstances. Our proposed study has taken an ambitious approach to gather samples from around the world and use high throughput genome sequecning to help understand the molecular underpinnings of this lethal disease.
|Epstein, Jonathan I; Amin, Mahul B; Beltran, Himisha et al. (2014) Proposed morphologic classification of prostate cancer with neuroendocrine differentiation. Am J Surg Pathol 38:756-67|
|Rubin, Mark A (2014) Insights into the mechanism of organ-specific cancer metastasis. Cancer Discov 4:1262-4|
|Gao, Dong; Vela, Ian; Sboner, Andrea et al. (2014) Organoid cultures derived from patients with advanced prostate cancer. Cell 159:176-87|
|Beltran, Himisha; Tomlins, Scott; Aparicio, Ana et al. (2014) Aggressive variants of castration-resistant prostate cancer. Clin Cancer Res 20:2846-50|
|Lin, Pei-Chun; Chiu, Ya-Lin; Banerjee, Samprit et al. (2013) Epigenetic repression of miR-31 disrupts androgen receptor homeostasis and contributes to prostate cancer progression. Cancer Res 73:1232-44|
|Lin, Pei-Chun; Giannopoulou, Eugenia G; Park, Kyung et al. (2013) Epigenomic alterations in localized and advanced prostate cancer. Neoplasia 15:373-83|
|Beltran, Himisha; Rubin, Mark A (2013) New strategies in prostate cancer: translating genomics into the clinic. Clin Cancer Res 19:517-23|
|Beltran, Himisha; Yelensky, Roman; Frampton, Garrett M et al. (2013) Targeted next-generation sequencing of advanced prostate cancer identifies potential therapeutic targets and disease heterogeneity. Eur Urol 63:920-6|
|Demichelis, Francesca; Setlur, Sunita R; Banerjee, Samprit et al. (2012) Identification of functionally active, low frequency copy number variants at 15q21.3 and 12q21.31 associated with prostate cancer risk. Proc Natl Acad Sci U S A 109:6686-91|
|Svensson, Maria A; LaFargue, Christopher J; MacDonald, Theresa Y et al. (2011) Testing mutual exclusivity of ETS rearranged prostate cancer. Lab Invest 91:404-12|
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