Principal Investigator: Rolf I. Skotheim. Other key investigators: Ragnhild A. Lothe (genetics/genomics), Karol Axcrona (clinician/surgeon), Ulrika Axcrona (uropathologist).

Prostate cancer is the most commonly diagnosed cancer in Norway (almost 5000 new cases in 2012; ref. Cancer Registry of Norway). Indeed, every third cancer in men is now in the prostate gland. Huge international projects are well underway to sequence a large series of prostate cancers to identify which genes are most commonly mutated. However, so far, a relatively simplified and uniform picture has been drawn by including only one malignant sample per patient. For prostate cancer, the mutational spectrum is often complex and heterogeneous, where different driver mutations are active within different tumour foci of the same patient/prostate.

The main aim of this project is to develop diagnostic and prognostic biomarkers for prostate cancer. To this end, we will carefully investigate the heterogeneity of DNA and RNA changes in multifocal prostate cancer and relate the data to clinicopathological parameters. Through the Norwegian Cancer Genomics Consortium we analyse the coding part of the genome (i.e. exome sequencing) from approximately 160 prostate samples (40 patients with 3 tumour and 1 normal samples each).

From the total biobank of 571 prostate cancer patients operated during 2010 to 2012 at the OUS-Radium Hospital, we have selected patients and samples to maximize the number of separate tumour foci from each patient. We have as well maximized the number of patients where we have clearly separate tumour foci where one is coupled with extra prostatic extension and other tumour foci are not. We will generate unprecedented data enabling exploration of whether samples from this invasive region carry mutations that are not found in non-invasive tumour foci within the same prostate.