Genomic Hallmarks and Structural Variation in Metastatic Prostate Cancer
Open accessAbstract
SUMMARY While mutations affecting protein-coding regions have been examined across many cancers, structural variants at the genome-wide level are still poorly defined. Through integrative deep whole genome and transcriptome analysis of 101 castration-resistant prostate cancer metastases (109X tumor / 38X normal coverage), we identified structural variants altering critical regulators of tumorigenesis and progression not detectable by exome approaches. Notably, we observed amplification of an intergenic enhancer region 624 kilobases upstream of the androgen receptor (AR) in 81% of patients, correlating with increased AR expression. Tandem duplication hotspots also occur near MYC, in lncRNAs associated with post-translational MYC regulation. Classes of structural variations were linked to distinct DNA repair deficiencies, suggesting their etiology, including associations of CDK12 mutation with tandem duplications, TP53 inactivation with inverted rearrangements and chromothripsis, and BRCA2 inactivation with deletions. Together, these observations provide a comprehensive view of how structural variations affect critical regulators in metastatic prostate cancer.
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Most prostate cancers express AR throughout the course of the disease.
“Most PCas express AR throughout the course of the disease2–5”
From Genome-scale CRISPR screens identify PTGES3 as a direct modulator of androgen receptor function in advanced prostate cancer (2025) · cites this paper as [2]
The Results section reports AR amplification in 70% of metastatic castration-resistant prostate cancer cases and associates it with elevated AR mRNA expression. That supports AR expression in many late-stage tumors, but the study sampled metastatic castration-resistant disease, not prostate cancers throughout their course; it does not establish expression across disease stages. (LLM, conf=0.80)
Experimental — accuracy not yet measuredThe androgen receptor (AR) is a critical/central driver of prostate cancer (PCa).
“The androgen receptor (AR) is a critical driver of prostate cancer (PCa).”
From Genome-scale CRISPR screens identify PTGES3 as a direct modulator of androgen receptor function in advanced prostate cancer (2025) · cites this paper as [2]
The Results (“A landscape of mutations and structural alterations,” page unavailable) report AR-related alterations in 85% of the metastatic castration-resistant prostate cancer samples, supporting AR’s importance in that setting. The claim refers to prostate cancer generally, while this paper’s findings concern its metastatic castration-resistant form. (LLM, conf=0.78)
Experimental — accuracy not yet measuredTumor alterations that reactivate AR signaling during treatment with an ARSI have been identified.
“We and other groups have identified tumor alterations that reactivate AR signaling during treatment with an ARSI2,22–29.”
From Genome-scale CRISPR screens identify PTGES3 as a direct modulator of androgen receptor function in advanced prostate cancer (2025) · cites this paper as [2]
The Results section (“Duplications target AR, MYC, and FOXA1”; page not provided) identifies AR and upstream-enhancer amplifications associated with increased AR expression. The Discussion links enhancer amplification to resistance following first-line androgen deprivation therapy, but the Results say it was not associated with prior abiraterone or enzalutamide treatment. The paper therefore supports the identification of alterations that increase AR expression, not specifically their emergence during treatment with an ARSI. (LLM, conf=0.85)
Experimental — accuracy not yet measuredMechanisms of ARSI resistance include AR gene amplification, AR enhancer amplification, AR mutation, AR genomic structural rearrangements, AR splice variants and polymorphisms in androgen metabolism genes.
“These mechanisms of resistance include AR gene amplification22,23, AR enhancer amplification2,24,25, AR mutation26, AR genomic structural rearrangements27, AR splice variants28 and polymorphisms in androgen metabolism genes29.”
From Genome-scale CRISPR screens identify PTGES3 as a direct modulator of androgen receptor function in advanced prostate cancer (2025) · cites this paper as [2]
The Results sections “Structural variations disrupt key driver genes” and “Duplications target AR, MYC, and FOXA1” identify AR-region structural variation, including tandem duplications associated with increased AR expression. The latter section and the Discussion suggest a role in resistance to first-line androgen-deprivation therapy, but the paper says enhancer amplification was not associated with prior abiraterone or enzalutamide treatment. It therefore does not establish these rearrangements as a mechanism of resistance to those AR-signaling inhibitors. (LLM, conf=0.84)
Experimental — accuracy not yet measuredDeep deletions (primarily of BRCA2) occur much more frequently in prostate cancer (33%) compared to other cancer types.
“However, deep deletions (primarily of BRCA2; Supplementary Fig. 23) occurred much more frequently in prostate cancer (33%) compared to other cancer types, consistent with previous observations28.”
From Pan-cancer landscape of homologous recombination deficiency. (2020) · cites this paper as [28]
The Results section, “A landscape of mutations and structural alterations” (page unavailable), reports BRCA2 inactivation and one deep deletion affecting MSH2 and MSH6. The Results section, “DNA repair defects drive SVs” (page unavailable), reports more deletions in tumors with biallelic BRCA2 mutations. Neither passage establishes that deep deletions are primarily of BRCA2, occur in 33% of prostate cancers, or are more frequent than in other cancer types; searches for those terms found no such comparison. (LLM, conf=0.75)
Experimental — accuracy not yet measured
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Self-citationDeep whole-genome ctDNA chronology of treatment-resistant prostate cancer
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Self-citationTargeting the Androgen Signaling Axis in Prostate Cancer
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Self-citationBiomarkers Associating with PARP Inhibitor Benefit in Prostate Cancer in the TOPARP-B Trial
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Self-citationBiological Evolution of Castration-resistant Prostate Cancer
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Genome-wide plasma DNA methylation features of metastatic prostate cancer
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Homologous Recombination and the Formation of Complex Genomic Rearrangements
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MEK-ERK signaling is a therapeutic target in metastatic castration resistant prostate cancer
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Self-citationStructural Variation in Cancer: Role, Prevalence, and Mechanisms
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Darolutamide is a potent androgen receptor antagonist with strong efficacy in prostate cancer models
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Illuminating the noncoding genome in cancer
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The Genomic and Epigenomic Landscape of Double-Negative Metastatic Prostate Cancer
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Self-citationA systematic review of the prevalence of DNA damage response gene mutations in prostate cancer
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Self-citationMolecular mechanisms underlying the development of neuroendocrine prostate cancer
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- Authors
- Quigley, D. A., Dang, H. X., Zhao, S. G., Lloyd, P., Aggarwal, R., Alumkal, J. J., Foye, A., Kothari, V., Perry, M. D., Bailey, A. M., Playdle, D., Barnard, T. J., Zhang, L., Zhang, J., Youngren, J. F., Cieslik, M. P., Parolia, A., Beer, T. M., Thomas, G., Chi, K. N., Gleave, M., Lack, N. A., Zoubeidi, A., Reiter, R. E., Rettig, M. B., Witte, O., Ryan, C. J., Fong, L., Kim, W., Friedlander, T., Chou, J., Li, H., Das, R., Li, H., Moussavi-Baygi, R., Goodarzi, H., Gilbert, L. A., Lara, P. N., Evans, C. P., Goldstein, T. C., Stuart, J. M., Tomlins, S. A., Spratt, D. E., Cheetham, R. K., Cheng, D. T., Farh, K., Gehring, J. S., Hakenberg, J., Liao, A., Febbo, P. G., Shon, J., Sickler, B., Batzoglou, S., Knudsen, K. E., He, H. H., Huang, J., Wyatt, A. W., Dehm, S. M., Ashworth, A., Chinnaiyan, A. M., Maher, C. A., Small, E. J., & Feng, F. Y.
- Affiliations
- University of California, San Francisco (US)
- Washington University in St. Louis (US)
- University of Michigan (US)
- Oregon Health & Science University (US)
- BC Cancer Agency (CA)
- University of British Columbia (CA)
- University of California, Los Angeles (US)
- University of Minnesota (US)
- University of California Davis Medical Center (US)
- University of California, Santa Cruz (US)
- Illumina (United States) (US)
- Thomas Jefferson University (US)
- University Health Network (CA)
- Duke University (US)
- Howard Hughes Medical Institute (US)
- Corresponding author
- Chinnaiyan, Arul M.
- Maher, Christopher A.
- Small, Eric J.
- Feng, Felix Y.
- ORCID
- Quigley, David A.
- Dang, Ha X.
- Zhao, Shuang G.
- Lloyd, Paul
- Aggarwal, Rahul
- Alumkal, Joshi J.
- Foye, Adam
- Kothari, Vishal
- Perry, Marc D.
- Zhang, Li
- Zhang, Jin
- Youngren, Jack F.
- Cieslik, Marcin P.
- Parolia, Abhijit
- Beer, Tomasz M.
- Thomas, George
- Chi, Kim N.
- Gleave, Martin
- Lack, Nathan A.
- Zoubeidi, Amina
- Reiter, Robert E.
- Rettig, Matthew B.
- Witte, Owen
- Ryan, Charles J.
- Fong, Lawrence
- Kim, Won
- Friedlander, Terence
- Chou, Jonathan
- Li, Haolong
- Das, Rajdeep
- Li, Hui
- Goodarzi, Hani
- Gilbert, Luke A.
- Lara, Primo N.
- Evans, Christopher P.
- Goldstein, Theodore C.
- Stuart, Joshua M.
- Tomlins, Scott A.
- Spratt, Daniel E.
- Farh, Kyle
- Gehring, Julian S.
- Hakenberg, Jörg
- Shon, John
- Sickler, Brad
- Batzoglou, Serafim
- Knudsen, Karen E.
- He, Housheng H.
- Huang, Jiaoti
- Wyatt, Alexander W.
- Dehm, Scott M.
- Ashworth, Alan
- Chinnaiyan, Arul M.
- Maher, Christopher A.
- Small, Eric J.
- Feng, Felix Y.
- Venue
- Cell
- Publisher
- Elsevier BV
- Published
- 2018-07
- Volume
- 174
- Issue
- 3
- Pages
- 758-769.e9
- ISSN
- 0092-8674 (ISSN-L)
- PMC
- PMC6425931
- OpenAlex
- W2884001931
- Semantic Scholar
- c72ffe522bd85597687b47e4d3db90ec72b4fc80
- Cited by
- 733
- References
- 73
- Citations by year
- 2026: 48 · 2025: 73 · 2024: 102 · 2023: 107 · 2022: 94 · 2021: 110 · 2020: 102 · 2019: 81 · 2018: 15
- FWCI
- 58.02
- Type
- journal article
- Language
- en
- Update notices
- erratum (2018-10-18)
- Open access
- bronze
- doi.org
- Licence
- Locations
- Cell (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- Stand Up To Cancer-Prostate Cancer Foundation Prostate Cancer Dream Team Award (SU2C-AACR-DT0812, SU2C-AACR-DT0712)
- Movember Foundation
- Goldberg-Benioff Research Fund for Prostate Cancer Translational Biology
- Prostate Cancer Foundation Challenge
- V Foundation
- BRCA Foundation Young Investigator Award
- Department of Defense (W81XWH-16-1-0747, W81XWH-15-1-0562, PC160429, W81XWH-17-1-0192)
- Early Detection Research Network (U01 CA214170)
- Prostate SPORE (P50 CA186786, P50 CA097186)
- NIH (R01CA174777)
- NCI T32 (CA108462)
- Prostate Cancer Foundation Young Investigator Awards
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Prostate Cancer Treatment and Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer Genomics and Diagnostics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Chromatin Remodeling and Cancer
- Keywords
- castration-resistant prostate cancer, metastatic prostate cancer, structural variants, androgen receptor, c-Myc, tandem duplication, long non-coding RNA, DNA repair deficiency, CDK12, TP53, chromothripsis, BRCA2
- MeSH terms
- Whole Genome Sequencing, Aged, Aged, 80 and over, Humans, Male, Middle Aged, Mutation, Neoplasm Metastasis, Prostatic Neoplasms, Receptors, Androgen, Tumor Suppressor Protein p53, Proto-Oncogene Proteins c-myc, Cyclin-Dependent Kinases, Tandem Repeat Sequences, Gene Expression Profiling, Genomics, BRCA2 Protein, Genomic Structural Variation, DNA Copy Number Variations, Exome
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