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BRAF alterations occur in about 3% of prostate cancers, primarily class II mutations and rearrangements, not V600 mutations. This unique BRAF activation pattern warrants further investigation into MAPK pathway-targeted therapies.

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Area of Science:

  • Oncology
  • Genomics
  • Molecular Biology

Background:

  • BRAF alterations are found in 3-5% of prostate cancers, but their specific nature requires further study.
  • Comprehensive genomic profiling (CGP) offers a method to characterize these alterations in a large patient cohort.

Purpose of the Study:

  • To characterize the nature of BRAF alterations in prostate cancer using CGP.
  • To compare BRAF alteration profiles in prostate cancer with other cancer types.
  • To investigate the association of BRAF alterations with patient ancestry.

Main Methods:

  • Utilized FoundationOne CDx and FoundationOne Liquid CDx CGP assays for tissue and liquid biopsies.
  • Analyzed 15,864 prostate cancer tissue biopsies and a large cohort of non-prostate cancer tissue biopsies (n=275,151) for comparison.
  • Employed a single-nucleotide polymorphism (SNP)-based approach to predict genetic ancestry.

Main Results:

  • BRAF-activating alterations were identified in 3.3% of prostate cancer tissue biopsies, with class II alterations (rearrangements, K601E, G469A) being most common.
  • BRAF-altered prostate cancers showed enrichment in CDK12 mutations and depletion in TMPRSS2 fusions, PTEN, and APC alterations compared to BRAF wild-type.
  • BRAF alterations were significantly more prevalent in patients of African and Asian ancestry compared to European ancestry.

Conclusions:

  • Approximately 3% of prostate cancers harbor activating BRAF alterations, predominantly class II mutations and rearrangements, with rare V600 mutations.
  • The distinct pattern of BRAF activation in prostate cancer suggests it differs from other cancer types.
  • These findings support further clinical research into BRAF-targeted therapies, specifically those inhibiting the mitogen-activated protein kinase (MAPK) pathway.