Recent controversies surrounding prostate cancer overtreatment emphasize the critical
need to delineate the molecular features associated with progression to lethal metastatic
disease. Here, we have used whole-genome sequencing and molecular pathological
analyses to characterize the lethal cell clone in a patient who died of prostate cancer. We
tracked the evolution of the lethal cell clone from the primary cancer to metastases through
samples collected during disease progression and at the time of death. Surprisingly, these …

Editorial Comment: The clinical relevance of heterogeneity of cancer within the prostate is a
hotly debated topic. Prostate cancer, perhaps more than other solid urological malignancies,
carries wide morphological and genetic heterogeneity within the prostate. It has been
previously suggested that metastatic disease in the patient with prostate cancer, while highly
heterogeneous in and of itself, arises from a single cell population in the prostate. In other
words while individual metastases take on new genetic mutations that may make the cells …