Aggressive cancers often possess functional and molecular traits characteristic of normal stem cells. It is unclear if aggressive phenotypes of prostate cancer molecularly resemble normal stem cells residing within the human prostate. Here, we transcriptionally profiled epithelial populations from the human prostate and show that aggressive prostate cancer is enriched for a prostate basal stem cell signature. Within prostate cancer metastases, histological subtypes had varying enrichment of the stem cell signature, with small cell neuroendocrine carcinoma being the most stem cell-like. We further found that small cell neuroendocrine carcinoma and the prostate basal stem cell share a common transcriptional program. Targeting normal stem cell transcriptional programs may provide a new strategy for treating advanced prostate cancer.

Abstract

Evidence from numerous cancers suggests that increased aggressiveness is accompanied by up-regulation of signaling pathways and acquisition of properties common to stem cells. It is unclear if different subtypes of late-stage cancer vary in stemness properties and whether or not these subtypes are transcriptionally similar to normal tissue stem cells. We report a gene signature specific for human prostate basal cells that is differentially enriched in various phenotypes of late-stage metastatic prostate cancer. We FACS-purified and transcriptionally profiled basal and luminal epithelial populations from the benign and cancerous regions of primary human prostates. High-throughput RNA sequencing showed the basal population to be defined by genes associated with stem cell signaling programs and invasiveness. Application of a 91-gene basal signature to gene expression datasets from patients with organ-confined or hormone-refractory metastatic prostate cancer revealed that metastatic small cell neuroendocrine carcinoma was molecularly more stem-like than either metastatic adenocarcinoma or organ-confined adenocarcinoma. Bioinformatic analysis of the basal cell and two human small cell gene signatures identified a set of E2F target genes common between prostate small cell neuroendocrine carcinoma and primary prostate basal cells. Taken together, our data suggest that aggressive prostate cancer shares a conserved transcriptional program with normal adult prostate basal stem cells.