TY - JOUR T1 - Hormone-sensitive prostate cancer: a case of ETS gene fusion heterogeneity JF - Journal of Clinical Pathology JO - J Clin Pathol SP - 373 LP - 376 DO - 10.1136/jcp.2008.061515 VL - 62 IS - 4 AU - G Attard AU - C Jameson AU - J Moreira AU - P Flohr AU - C Parker AU - D Dearnaley AU - C S Cooper AU - J S de Bono Y1 - 2009/04/01 UR - http://jcp.bmj.com/content/62/4/373.abstract N2 - 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. ER -