Prostate cancer has variable manifestations, ranging from relatively benign localized tumors to widespread life-threatening metastases. The origin of most prostate cancer metastases can be traced back to the primary tumor; therefore, understanding the mutations in the primary tumor that promote cancer spread is of great interest.
In this issue of the Journal of Clinical Investigation, Srinivasan Yegnasubramanian and colleagues at Johns Hopkins University track the development of lethal prostate cancer in a patient. Using tissue samples taken throughout the progression of the cancer, the authors identified the origin of the lethal clone. Surprisingly, in this case the lethal clone originated from a small, low-grade foci in the primary tumor and not from the larger high-grade region of the tumor.
In the accompanying commentary, Rose Brannon and Charles Sawyers of Memorial Sloan-Kettering Cancer Center discuss the importance of individual case studies and how a comprehensive database of such studies is needed to identify common patterns in cancer progression.
Tracking the clonal origin of lethal prostate cancer, J Clin Invest. DOI: 10.1172/JCI70354
"N of 1" case reports in the era of whole-genome sequencing, J Clin Invest. 2013;123(11):4568–4570. DOI: 10.1172/JCI70935