Multimodal pathology assessment of prostate cancer for precision medicine – a pilot study utilising next generation sequencing and image analysis.

Elysia Upton, Rao Rao Srinivasa, Nasullah Khalid Alham,  Richard J Bryant, Lucy Cerundolo,  Freddie C Hamdy, Ian Tomlinson, David Wedge, Jens Rittscher, Clare Verrill

Prostate cancer is a major global health issue.  One of the major challenges is correctly stratifying men into prognostic groups and identifying suitable modes of therapy. Histopathological assessment of prostate cancers remains virtually unchanged over several decades, relying on pathologist evaluation of morphological parameters such as Gleason grading.   In other tumour types, assessment has moved on to routinely integrate next generation sequencing and there is much interest in the role of inflammatory cells and tumour progression.  Links have been made in colorectal cancer between mutation status and degree of inflammatory infiltrate, with hyper-mutated carcinomas showing prominent inflammatory infiltrates.  This study aims to pilot evaluation of prostate cancer in a multimodal way, incorporating both next generation sequencing and image analysis.