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- Title
Bone biopsy protocol for advanced prostate cancer in the era of precision medicine.
- Authors
Sailer, Verena; Schiffman, Marc H.; Kossai, Myriam; Cyrta, Joanna; Beg, Shaham; Sullivan, Brian; Pua, Bradley B.; Lee, Kyungmouk Steve; Talenfeld, Adam D.; Nanus, David M.; Tagawa, Scott T.; Robinson, Brian D.; Rao, Rema A.; Pauli, Chantal; Bareja, Rohan; Beltran, Luis S.; Sigaras, Alexandros; Eng, Kenneth Wa; Elemento, Olivier; Sboner, Andrea
- Abstract
<bold>Background: </bold>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.<bold>Methods: </bold>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.<bold>Results: </bold>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.<bold>Conclusions: </bold>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;124:1008-15. © 2017 American Cancer Society.
- Subjects
BONE biopsy; PROSTATE cancer patients; PROSTATE cancer treatment; BONE metastasis; BLOOD coagulation
- Publication
Cancer (0008543X), 2018, Vol 124, Issue 5, p1008
- ISSN
0008-543X
- Publication type
journal article
- DOI
10.1002/cncr.31173