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Fraser. J Transl Genet Genom 2018;2:21 Journal of Translational
DOI: 10.20517/jtgg.2018.27 Genetics and Genomics

Review Open Access

The somatic clinico-genomics of localized, non-
indolent prostate cancer

Michael Fraser

Ontario Institute for Cancer Research, Toronto, ON M5G 0A3, Canada.
Correspondence to: Dr. Michael Fraser, Ontario Institute for Cancer Research, 661 University Avenue, Toronto, ON M5G 0A3, Canada.
E-mail: michael.fraser@oicr.on.ca

How to cite this article: Fraser M. The somatic clinico-genomics of localized, non-indolent prostate cancer. J Transl Genet Genom
2018;2:21. https://doi.org/10.20517/jtgg.2018.27
Received: 6 Sep 2018 First Decision: 11 Sep 2018 Revised: 14 Nov 2018 Accepted: 14 Nov 2018 Published: 18 Dec 2018

Science Editor: David N. Cooper Copy Editor: Cui Yu Production Editor: Huan-Liang Wu

Abstract

Prostate cancer is the second most frequently diagnosed non-skin male malignancy worldwide, with over 1.1 million
new diagnoses each year. Population screening based on serum prostate-specific antigen (PSA) has shifted the disease
burden toward earlier stage, localized disease. However, clinical outcomes for localized prostate cancer are highly
heterogeneous, despite the use of clinical prognostic factors (PSA, Gleason grade, and TNM stage). Recent advances in
massively-parallel DNA sequencing and computational biology have permitted detailed genomic analyses of all major
human cancer types, including prostate cancer. However, the long natural history of prostate cancer has largely precluded
rapid translation of this knowledge into clinical practice. Herein, we provide a “state of the field” overview of prostate
cancer genomics, with particular focus on localized, non-indolent disease. We discuss recurrent somatic aberrations,
across multiple mutational classes, which characterize this disease state, and suggest strategies through which an
improved understanding of these molecular aberrations may be utilized in the curative setting. Finally, we summarize
the major outstanding questions in prostate cancer genomics, and discuss hypotheses and potential strategies to begin
to address these questions.

Keywords: Prostate cancer, genomics, biomarkers, clinical outcome

INTRODUCTION
Prostate cancer is the most frequently diagnosed non-skin male malignancy in Western countries, with over
500,000 new diagnoses each year in North America and Europe alone. Since the introduction of prostate-
specific antigen (PSA) screening in the early 1990s, the vast majority of new cases are diagnosed as organ-
confined, potentially-curable disease, with very few diagnoses of primary metastatic disease in screened

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
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