Molecular medicine tumor board: whole-genome sequencing to inform on personalized medicine for a man with advanced prostate cancer.

Molecular profiling of cancer is increasingly common as part of routine care in oncology, and germline and somatic profiling may provide insights and actionable targets for men with metastatic prostate cancer.

However, all reported cases are of deidentified individuals without full medical and genomic data available in the public domain.

We present a case of whole-genome tumor and germline sequencing in a patient with advanced prostate cancer, who has agreed to make his genomic and clinical data publicly available.

We describe an 84-year-old Caucasian male with a Gleason 10 oligometastastic hormone-sensitive prostate cancer. Whole-genome sequencing provided insights into his tumor's underlying mutational processes and the development of an SPOP mutation. It also revealed an androgen-receptor dependency of his cancer which was reflected in his durable response to radiation and hormonal therapy. Potentially actionable genomic lesions in the tumor were identified through a personalized medicine approach for potential future therapy, but at the moment, he remains in remission, illustrating the hormonal sensitivity of his SPOP-driven prostate cancer. We also placed this patient in the context of a large prostate-cancer cohort from the PCAWG (Pan-cancer Analysis of Whole Genomes) group. In this comparison, the patient's cancer appears typical in terms of the number and type of somatic mutations, but it has a somewhat larger contribution from the mutational process associated with aging.

We combined the expertise of medical oncology and genomics approaches to develop a molecular tumor board to integrate the care and study of this patient, who continues to have an outstanding response to his combined modality treatment. This identifiable case potentially helps overcome barriers to clinical and genomic data sharing.

Prostate cancer and prostatic diseases. 2021 Feb 10 [Epub ahead of print]

Andrew J Armstrong, Xiaotong Li, Matthew Tucker, Shantao Li, Xinmeng Jasmine Mu, Kenneth Wha Eng, Andrea Sboner, Mark Rubin, Mark Gerstein

Duke Cancer Institute Center for Prostate and Urologic Cancer, Departments of Medicine, Surgery, Pharmacology and Cancer Biology, Duke Cancer Institute, Durham, NC, USA. ., Program in Computational Biology and Bioinformatics, Yale University, New Haven, CT, USA., Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA., The Broad Institute of MIT & Harvard, Cambridge, MA, USA., Department of Physiology and Biophysics, Englander Institute for Precision Medicine, HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Weill Cornell Medical College, New York, NY, USA., Department of Pathology and Laboratory Medicine, Englander Institute for Precision Medicine, HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Meyer Cancer Center, Weill Cornell Medical College, New York, NY, USA., Department of Pathology and Laboratory Medicine, Englander Institute for Precision Medicine, HRH Prince Alwaleed Bin Talal Bin Abdulaziz Alsaud Institute for Computational Biomedicine, Meyer Cancer Center, Weill Cornell Medical College, New York, NY, USA. ., Program in Computational Biology and Bioinformatics, Yale University, New Haven, CT, USA. .

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