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Adverse prognosis gene expression patterns in metastatic castration-resistant prostate cancer
Carbone Cancer Center, University of Wisconsin-Madison, WI, United States; Department of Medicine, University of Wisconsin-Madison, WI, United States.
Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, United States; Department of Radiation Oncology, University of California, San Francisco, CA, United States.
Department of Human Oncology, University of Wisconsin-Madison, WI, United States.
Carbone Cancer Center, University of Wisconsin-Madison, WI, United States; Department of Medicine, University of Wisconsin-Madison, WI, United States.
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2025 (English)In: Molecular Oncology, ISSN 1574-7891, E-ISSN 1878-0261Article in journal (Refereed) Epub ahead of print
Abstract [en]

Metastatic castration-resistant prostate cancer (mCRPC) is a heterogeneous disease. Several studies have identified transcriptional subtypes of mCRPC, but comprehensive analysis of prognostic gene expression pathways has been limited. Therefore, we aggregated a cohort of 1012 mCRPC tissue samples from 769 patients and investigated the association of gene expression-based pathways with clinical outcomes and intrapatient and intratumor heterogeneity. Survival data were obtained for 272 patients. Pathway-level enrichment was evaluated using gene set variation analysis. scRNA-seq datasets from mCRPC tissue biopsies and circulating tumor cells were used to investigate heterogeneity of adverse pathways. We identified five pathway clusters: (a) Immune response/WNT/TGF-beta signaling, (b) AR signaling/luminal signatures, (c) mTOR signaling and glycolysis, (d) cell proliferation, and (e) neuroendocrine differentiation. Proliferation, AR signaling loss, and glycolysis/mTOR signaling were independently prognostic. Adverse prognostic pathway scores decreased on treatment with AR signaling inhibitors, but not at progression, suggesting failure to permanently target these pathways. scRNA-seq datasets from mCRPC tissue biopsies and circulating tumor cells were used to investigate heterogeneity of adverse pathways. Our results suggest loss of AR signaling, high proliferation, and a glycolytic phenotype as adverse prognostic pathways in mCRPC that could be used in conjunction with clinical factors to prognosticate for treatment decisions.

Place, publisher, year, edition, pages
John Wiley & Sons, 2025.
Keywords [en]
biomarker, gene expression, metastatic castration-resistant prostate cancer, precision medicine, prognosis
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Cancer and Oncology
Identifiers
URN: urn:nbn:se:umu:diva-236193DOI: 10.1002/1878-0261.70001ISI: 001429089900001PubMedID: 39985777Scopus ID: 2-s2.0-85218705563OAI: oai:DiVA.org:umu-236193DiVA, id: diva2:1944266
Funder
Swedish Cancer Society, 2021-1856ProstatacancerförbundetKnut and Alice Wallenberg FoundationAvailable from: 2025-03-13 Created: 2025-03-13 Last updated: 2025-03-13

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Josefsson, AndreasWikström, Pernilla
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Department of Diagnostics and InterventionWallenberg Centre for Molecular Medicine at Umeå University (WCMM)Pathology
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CiteExportLink to record
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