Metastases to the brain are rare in prostate cancer. Here, we describe a patient with two treatment-emergent metastatic lesions, one to the brain with neuroendocrine prostate cancer (NEPC) histology and one to the dural membrane of adenocarcinoma histology. We performed genomic, transcriptomic, and proteomic characterization of these lesions and the primary tumor to investigate molecular features promoting these metastases. The two metastatic lesions had high genomic similarity, including TP53 mutation and PTEN deletion, with the most striking difference being the additional loss of RB1 in the NEPC lesion. Interestingly, the dural lesion expressed both androgen receptor and neuroendocrine markers, suggesting amphicrine carcinoma (AMPC). When analyzing pioneer transcription factors, the AMPC lesion exhibited elevated FOXA1 activity while the brain NEPC lesion showed elevated HOXC10, NFYB, and OTX2 expression suggesting novel roles in NEPC formation or brain tropism. Our results highlight the utility of performing multi-omic characterization, especially in rare cancer subtypes.
NPJ precision oncology. 2024 Sep 30*** epublish ***
Megan L Ludwig, David Moline, Alec Horrmann, Ella Boytim, Gabrianne Larson, Ali T Arafa, Masooma Sayeda, John R Lozada, Hannah E Bergom, Abderrahman Day, Sandhyarani Dasaraju, Scott M Dehm, Paari Murugan, Justin Hwang, Justin M Drake, Emmanuel S Antonarakis
Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA., Department of Medicine, Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, MN, USA., Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, USA., Department of Pharmacology, University of Minnesota, Minneapolis, MN, USA. ., Department of Medicine, Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, MN, USA. .