Characteristics of BRCA2 Mutated Prostate Cancer at Presentation.

Genetic alterations of DNA repair genes, particularly BRCA2 in patients with prostate cancer, are associated with aggressive behavior of the disease. It has reached consensus that somatic and germline tests are necessary when treating advanced prostate cancer patients. Yet, it is unclear whether the mutations are associated with any presenting clinical features. We assessed the incidences and characteristics of mutated cancers by targeted sequencing in 126 sets of advanced prostate cancer tissue sequencing data. At the time of diagnosis, cT3/4, N1 and M1 stages were 107 (85%), 54 (43%) and 35 (28%) samples, respectively. alterations of clinical significance by AMP/ASCO/CAP criteria were found in 19 of 126 samples (15.1%). The mutated cancer did not differ in the distributions of TNM stage, Gleason grade group or histological subtype compared to wild-type cancers. Yet, they had higher tumor mutation burden, and higher frequency of and mutations (44% vs. 10%, = 0.002 and 21% vs. 4%, = 0.018, respectively). Of the metastatic subgroup (M1, n = 34), mean PSA was significantly lower in mutated cancers than wild-type ( = 0.018). In the non-metastatic subgroup (M0, n = 64), PSA was not significantly different ( = 0.425). A similar trend was noted in multiple metastatic prostate cancer public datasets. We conclude that mutated metastatic prostate cancers may present in an advanced stage with relatively low PSA.