Bone biopsy protocol for advanced prostate cancer in the era of precision medicine.
Cancer
; 124(5): 1008-1015, 2018 03 01.
Article
in En
| MEDLINE
| ID: mdl-29266381
ABSTRACT
BACKGROUND:
Metastatic biopsies are increasingly being performed in patients with advanced prostate cancer to search for actionable targets and/or to identify emerging resistance mechanisms. Due to a predominance of bone metastases and their sclerotic nature, obtaining sufficient tissue for clinical and genomic studies is challenging.METHODS:
Patients with prostate cancer bone metastases were enrolled between February 2013 and March 2017 on an institutional review board-approved protocol for prospective image-guided bone biopsy. Bone biopsies and blood clots were collected fresh. Compact bone was subjected to formalin with a decalcifying agent for diagnosis; bone marrow and blood clots were frozen in optimum cutting temperature formulation for next-generation sequencing. Frozen slides were cut from optimum cutting temperature cryomolds and evaluated for tumor histology and purity. Tissue was macrodissected for DNA and RNA extraction, and whole-exome sequencing and RNA sequencing were performed.RESULTS:
Seventy bone biopsies from 64 patients were performed. Diagnostic material confirming prostate cancer was successful in 60 of 70 cases (85.7%). The median DNA/RNA yield was 25.5 ng/µL and 16.2 ng/µL, respectively. Whole-exome sequencing was performed successfully in 49 of 60 cases (81.7%), with additional RNA sequencing performed in 20 of 60 cases (33.3%). Recurrent alterations were as expected, including those involving the AR, PTEN, TP53, BRCA2, and SPOP genes.CONCLUSIONS:
This prostate cancer bone biopsy protocol ensures a valuable source for high-quality DNA and RNA for tumor sequencing and may be used to detect actionable alterations and resistance mechanisms in patients with bone metastases. Cancer 2018;1241008-15. © 2017 American Cancer Society.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Prostate
/
Prostatic Neoplasms
/
Bone and Bones
/
Bone Neoplasms
Type of study:
Guideline
/
Observational_studies
/
Risk_factors_studies
Limits:
Aged
/
Aged80
/
Humans
/
Male
/
Middle aged
Language:
En
Year:
2018
Type:
Article