Resumen
We treat prostate cancer like it is one disease, but it is clear that it behaves like different diseases in different patients, with some having excellent responses to hormonal therapies and prolonged survivals, and others having virulent, aggressive courses and short survivals. These differences reflect different tumor biologies and therapeutic sensitivities, but the absence of molecular markers that identify each of these subsets makes it difficult to develop treatments specific to each. We found that alterations in two or more of the tumor suppressors TP53, RB1 and PTEN characterize the more virulent prostate cancers, and that patients with this molecular profile (called the aggressive variant prostate cancer molecular profile) appear to benefit more from combination chemotherapies than those without. The alterations in these markers can be determined either by staining tumor tissues or by examining their DNA. In this study, we used 28 mouse models of the human disease to assess the performance of various assays in determining these alterations. We found that although both staining and DNA sequencing are complementary, staining (which is a broadly available technique) is likely sufficient to make these determinations. Our results will inform the use of this molecular signature in clinical research and clinical practice.