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Abstract
Neuroendocrine prostate cancer is an aggressive variant of prostate cancer that may arise de novo or develop from pre-existing prostate adenocarcinoma as a mechanism of treatment resistance. The combined loss of tumor suppressors RB1, TP53, and PTEN are frequent in NEPC but also present in a subset of prostate adenocarcinomas. Most clinical and preclinical studies support a trans-differentiation process, whereby NEPC arises clonally from a prostate adenocarcinoma precursor during the course of treatment resistance. Here we highlight a case of NEPC with significant intra-patient heterogeneity observed across metastases. We further demonstrate how single-cell genomic analysis of circulating tumor cells combined with a phenotypic evaluation of cellular diversity can be considered as a window into tumor heterogeneity in patients with advanced prostate cancer.
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1 Dana Farber Cancer Institute and Harvard Medical School, Boston, USA (GRID:grid.65499.37) (ISNI:0000 0001 2106 9910); IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, Meldola, Italy (GRID:grid.65499.37)
2 Dana Farber Cancer Institute and Harvard Medical School, Boston, USA (GRID:grid.65499.37) (ISNI:0000 0001 2106 9910)
3 Epic Sciences, Inc., San Diego, USA (GRID:grid.509720.9)
4 Weill Cornell Medicine, New York, USA (GRID:grid.5386.8) (ISNI:000000041936877X)
5 Dana Farber Cancer Institute and Harvard Medical School, Boston, USA (GRID:grid.65499.37) (ISNI:0000 0001 2106 9910); Weill Cornell Medicine, New York, USA (GRID:grid.5386.8) (ISNI:000000041936877X)