Hormone-sensitive prostate cancer: A case of ETS gene fusion heterogeneity

G. Attard, C. Jameson, J. Moreira, P. Flohr, C. Parker, D. Dearnaley, C. S. Cooper, J. S. De Bono

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22 Citations (Scopus)


Fusion of the hormone-regulated gene TMPRSS2 with ERG occurs in 50-70% of prostate cancers; fusions of ETV1 with one of several partners occur in approximately 10% of prostate cancers. These two translocations are mutually exclusive. The presence of subclasses of these chromosomal rearrangements may indicate worse prognosis, with the subclass 2+Edel, which has duplication of TMPRSS2:ERG fusion sequences, indicating particularly poor survival. However as this case shows, significant heterogeneity can exist with ERG and ETV7 rearrangements occurring in both prostate intra-epithelial neoplasia and cancer in the same prostatectomy specimen and with adjacent cancer areas containing a single copy, duplication and even triplication of the rearranged locus. As the majority of ETS gene fusions are hormone regulated, they could explain the pathogenesis underlying exquisitely hormone-sensitive prostate cancer. This is exemplified by the case presented here of a patient diagnosed in 1991 who remains asymptomatic and chemotherapy-naive after having long-lasting tumour responses to multiple lines of systemic hormonal treatments.

Original languageEnglish
Pages (from-to)373-376
Number of pages4
JournalJournal of Clinical Pathology
Issue number4
Publication statusPublished - 17 Nov 2008

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