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Updated: Jun 27, 2026

Microarray-based Identification of Individual HERV Loci Expression: Application to Biomarker Discovery in Prostate Cancer
Published on: November 2, 2013
Hormone-sensitive prostate cancer: a case of ETS gene fusion heterogeneity
Abstract:
Fusion of the hormone-regulated gene TMPRSS2 with ERG occurs in 50-70% of prostate cancers; fusions of ETV1 with one of several partners occur in approximately 10% of prostate cancers. These two translocations are mutually exclusive. The presence of subclasses of these chromosomal rearrangements may indicate worse prognosis, with the subclass 2+Edel, which has duplication of TMPRSS2:ERG fusion sequences, indicating particularly poor survival. However as this case shows, significant heterogeneity can exist with ERG and ETV1 rearrangements occurring in both prostate intra-epithelial neoplasia and cancer in the same prostatectomy specimen and with adjacent cancer areas containing a single copy, duplication and even triplication of the rearranged locus. As the majority of ETS gene fusions are hormone regulated, they could explain the pathogenesis underlying exquisitely hormone-sensitive prostate cancer. This is exemplified by the case presented here of a patient diagnosed in 1991 who remains asymptomatic and chemotherapy-naïve after having long-lasting tumour responses to multiple lines of systemic hormonal treatments.
Insights
Prostate cancer often involves gene fusions like TMPRSS2:ERG and ETV1, which can predict prognosis. This study highlights the heterogeneity of these rearrangements and their link to hormone-sensitive prostate cancer.
Area of Science:
- Oncology
- Genetics
- Molecular Biology
Background:
- TMPRSS2:ERG gene fusions are prevalent in 50-70% of prostate cancers, while ETV1 fusions occur in about 10%, and these events are mutually exclusive.
- Specific chromosomal rearrangements, such as the 2+Edel subclass with duplicated TMPRSS2:ERG sequences, are associated with a poorer prognosis in prostate cancer patients.
Observation:
- Significant heterogeneity in ERG and ETV1 rearrangements has been observed within the same prostatectomy specimen, affecting both intraepithelial neoplasia and cancerous tissues.
- Adjacent cancerous areas can exhibit varying copy numbers of the rearranged locus, ranging from single copies to duplications and triplications.
Findings:
- The majority of ETS gene fusions are hormone-regulated, suggesting a role in the pathogenesis of hormone-sensitive prostate cancer.
- A case study demonstrates a patient with long-lasting tumor responses to hormonal treatments, remaining asymptomatic and chemotherapy-naïve since 1991, exemplifying the link between gene fusions and hormone sensitivity.
Implications:
- Understanding the heterogeneity and specific subclasses of these gene rearrangements is crucial for accurate prognosis and personalized treatment strategies in prostate cancer.
- The hormone-regulated nature of ETS gene fusions provides a molecular basis for the efficacy of hormonal therapies in a subset of prostate cancer patients.
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