Regents of the University of Michigan Ann Arbor United States
Prostate cancer is commonly multiclonal, meaning that most men with prostate cancer have multiple, genetically distinct cancers. Pathologists cannot assess clonally by routine microscopic evaluation, and hence multiclonality is not incorporated into routinely reported pathological parameters, such as the number of cores with cancer. Given the importance of routine pathological parameters in prostate cancer prognosis, the potential to refine these parameters through assessing multiclonality represents a major opportunity. Hence, the objectives of this proposal are to utilize dual ERGSPINK1 immunohistochemistry IHCwhich can identify clonal, mutually exclusive molecular subtypes to assess the frequency multiclonality in key clinical scenarios at biopsy and resection and its impact on prognostic parameters. We have published initial findings from this proposal that confirm multiclonality in key diagnostic scenarios and our ongoing work supports relevant multifocality in other important scenarios.