RESEARCH ARTICLE
App aising he ele ance o DNA copy
numbe loss and gain in p os a e cance using
whole genome DNA sequence da a
Niedzica Camacho
1,2,3
, Pe e Van Loo
4,5
, Sand a Edwa ds
1
, Jona han D. Kay
6,7
,
Lucy Ma hews
1
, Ke s in Haase
4
, Je emy Cla k
8
, Nening Dennis
9
, Sa ah Thomas
9
,
Ba ba a K emeye
10
, Jo ge Zamo a
10
, Adam P. Bu le
10
, Gunes Gundem
10,11
,
Sue Me son
1
, Hayley Lux on
6,7
, S e e Hawkins
6
, Mohammed Gho i
10
, Luke Ma sden
12
,
Adam Lambe
13
, Ka alin Ka aszi
13,14
, Gill Pel ende
14
, Cha lie E. Massie
6,15
, Zso ia Ko e-
Ja ai
1
, Kei an Raine
10
, Da id Jones
10
, William J. Howa
16
, S e en Hazell
9
, Naomi Li ni
9
,
Cy il Fishe
9
, Ch is ophe Ogden
9
, Pa deep Kuma
9
, Alan Thompson
9
, Da id Nicol
9
,
E ik Maye
9
, Tim Dudde idge
9
, Yongwei Yu
17
, Hongwei Zhang
17
, Nimish C. Shah
18
,
Vincen J. Gnanap agasam
19
, The CRUK-ICGC P os a e G oup
¶
, William Isaacs
20
,
Tapio Visako pi
21
, F eddie Hamdy
14
, Dan Be ney
22
, Cla e Ve ill
23
, Anne Y. Wa en
18
,
Da id C. Wedge
10,24
, And ew G. Lynch
25,26‡
, Ch is ophe S. Fos e
27‡
, Yong Jie Lu
22
,
G. S e en Bo a
21‡
, Hayley C. Whi ake
6,7
, Ul an McDe mo
10‡
, Da id E. Neal
6,19‡
,
Rosalind Eeles
1,9‡
, Colin S. Coope
1,8‡
, Daniel S. B ewe
8,28‡
*
1Di ision o Gene ics and Epidemiology, The Ins i u e O Cance Resea ch, London, Uni ed Kingdom,
2Human Oncology and Pa hogenesis P og am, Memo ial Sloan Ke e ing Cance Cen e , New Yo k, New
Yo k, Uni ed S a es o Ame ica, 3Ma ie-Jose
´e and Hen y R. K a is Cen e o Molecula Oncology, Memo ial
Sloan Ke e ing Cance Cen e , New Yo k, New Yo k, Uni ed S a es o Ame ica, 4Cance Genomics
Labo a o y, The F ancis C ick Ins i u e, London, Uni ed Kingdom, 5Depa men o Human Gene ics,
Uni e si y o Leu en, Leu en, Belgium, 6U o-Oncology Resea ch G oup, Cance Resea ch UK Camb idge
Ins i u e, Camb idge, Camb idgeshi e, Uni ed Kingdom, 7Molecula Diagnos ics and The apeu ics G oup,
Uni e si y College London, London, Uni ed Kingdom, 8No wich Medical School, Uni e si y o Eas Anglia,
No wich, No olk, Uni ed Kingdom, 9Cance Gene ics Uni , Royal Ma sden NHS Founda ion T us , London,
Uni ed Kingdom, 10 Cance , Ageing and Soma ic Mu a ion, Wellcome T us Sange Ins i u e, Hinx on,
Camb idgeshi e, Uni ed Kingdom, 11 Epidemiology & Bios a is ics, Memo ial Sloan-Ke e ing Cance Cen e ,
New Yo k, New Yo k, Uni ed S a es o Ame ica, 12 Depa men o Physiology, Uni e si y o Ox o d, Ox o d,
Ox o dshi e, Uni ed Kingdom, 13 Depa men o Oncology, CRUK/MRC Ox o d Ins i u e o Radia ion
Oncology, Ox o d, Ox o dshi e, Uni ed Kingdom, 14 Nu ield Depa men o Su gical Sciences, Uni e si y o
Ox o d, Ox o d, Ox o dshi e, Uni ed Kingdom, 15 CRUK Camb idge Cen e, Ea ly De ec ion P og amme,
U ological Malignancies P og amme, Hu chison-MRC Resea ch Cen e, Camb idge, Camb idgeshi e, Uni ed
Kingdom, 16 His opa hology and in si u hyb idiza ion Resea ch G oup, Cance Resea ch UK Camb idge
Ins i u e, Camb idge, Camb idgeshi e, Uni ed Kingdom, 17 Depa men o Epidemiology, Second Mili a y
Medical Uni e si y, Shanghai, China, 18 Depa men o His opa hology, Camb idge Uni e si y Hospi als NHS
Founda ion T us , Camb idge, Camb idgeshi e, Uni ed Kingdom, 19 Academic U ology G oup, Depa men
o Su ge y, Uni e si y o Camb idge, Camb idge, Camb idgeshi e, Uni ed Kingdom, 20 School o Medicine,
Johns Hopkins Uni e si y, Bal imo e, Ma yland, Uni ed S a es o Ame ica, 21 Facul y o Medicine and Li e
Sciences and BioMediTech Ins i u e, Uni e si y o Tampe e and Tampe e Uni e si y Hospi al, Tampe e,
Finland, 22 Cen e o Molecula Oncology, Ba s Cance Ins i u e, The Ba s and London School o Medicine
and Den is y, Queen Ma y Uni e si y o London, London, Uni ed Kingdom, 23 Depa men o Cellula
Pa hology and Ox o d Biomedical Resea ch Cen e, Ox o d Uni e si y Hospi als NHS T us , Ox o d,
Ox o dshi e, Uni ed Kingdom, 24 Ox o d Big Da a Ins i u e & Ox o d Cen e o Cance Gene Resea ch,
Wellcome T us Cen e o Human Gene ics, Ox o d, Ox o dshi e, Uni ed Kingdom, 25 S a is ics and
Compu a ional Biology Labo a o y, Cance Resea ch UK Camb idge Ins i u e, Camb idge, Camb idgeshi e,
Uni ed Kingdom, 26 School o Ma hema ics and S a is ics/School o Medicine, Uni e si y o S And ews, S
And ews, Fi e, Sco land, 27 HCA Pa hology Labo a o ies, HCA Heal hca e, London, Uni ed Kingdom,
28 O ganisms and Ecosys ems, The Ea lham Ins i u e, No wich, No olk, Uni ed Kingdom
‡ CSC and DSB a e join senio au ho s on his wo k. AGL, CSF, GSB, UM, DEN, RE, CSC, and DSB a e
senio p incipal in es iga o s o his p ojec and he CRUK-ICGC P os a e G oup.
¶ Membe ship o he CRUK-ICGC P os a e G oup is p o ided in S3 Appendix.
*[email p o ec ed]
PLOS Gene ics | h ps://doi.o g/10.1371/jou nal.pgen.1007001 Sep embe 25, 2017 1 / 28
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OPEN ACCESS
Ci a ion: Camacho N, Van Loo P, Edwa ds S, Kay
JD, Ma hews L, Haase K, e al. (2017) App aising
he ele ance o DNA copy numbe loss and gain in
p os a e cance using whole genome DNA
sequence da a. PLoS Gene 13(9): e1007001.
h ps://doi.o g/10.1371/jou nal.pgen.1007001
Edi o : Rameen Be oukhim, B oad Ins i u e,
UNITED STATES
Recei ed: Feb ua y 15, 2017
Accep ed: Augus 28, 2017
Published: Sep embe 25, 2017
Copy igh : ©2017 Camacho e al. This is an open
access a icle dis ibu ed unde he e ms o he
C ea i e Commons A ibu ion License, which
pe mi s un es ic ed use, dis ibu ion, and
ep oduc ion in any medium, p o ided he o iginal
au ho and sou ce a e c edi ed.
Da a A ailabili y S a emen : All whole genome
sequencing iles and SNP6 iles a e a ailable om
he Eu opean Genome-phenome A chi e (da abase
accession numbe EGAS00001000262).
Funding: We acknowledge suppo om Cance
Resea ch UK (C5047/A22530, C309/A11566,
C368/A6743, A368/A7990, C14303/A17197) and
he Dallaglio Founda ion. We also acknowledge
suppo om he Na ional Ins i u e o Heal h
Resea ch (NIHR) (The Biomedical Resea ch Cen e
a The Ins i u e o Cance Resea ch & The Royal
Abs ac
A a ie y o models ha e been p oposed o explain egions o ecu en soma ic copy num-
be al e a ion (SCNA) in human cance . Ou s udy employs Whole Genome DNA Sequence
(WGS) da a om umo samples (n = 103) o comp ehensi ely assess he ole o he Knud-
son wo hi gene ic model in SCNA gene a ion in p os a e cance . 64 ecu en egions o
loss and gain we e de ec ed, o which 28 we e no el, including egions o loss wi h mo e
han 15% equency a Ch 4p15.2-p15.1 (15.53%), Ch 6q27 (16.50%) and Ch 18q12.3
(17.48%). Comp ehensi e mu a ion sc eens o genes, lincRNA encoding sequences, con-
ol egions and conse ed domains wi hin SCNAs demons a ed ha a wo-hi gene ic
model was suppo ed in only a mino p opo ion o ecu en SCNA losses examined (15/
40). We ound ha ecu en b eakpoin s and egions o in e sion o en occu wi hin Knud-
son model SCNAs, leading o he iden i ica ion o ZNF292 as a a ge gene o he dele ion
a 6q14.3-q15 and NKX3.1as a wo-hi a ge a 8p21.3-p21.2. The impo ance o al e a ions
o lincRNA sequences was illus a ed by he iden i ica ion o a no el mu a ional ho spo a
he KCCAT42,FENDRR,CAT1886 and STCAT2 loci a he 16q23.1-q24.3 loss. Ou da a
con i m ha he bu den o SCNAs is p edic i e o biochemical ecu ence, de ine nine indi-
idual egions ha a e associa ed wi h elapse, and highligh he possible impo ance o ion
channel and G-p o ein coupled- ecep o (GPCR) pa hways in cance de elopmen . We con-
cluded ha a wo-hi gene ic model accoun s o abou one hi d o SCNA indica ing ha
mechanisms, such haploinsu iciency and epigene ic inac i a ion, accoun o he emaining
SCNA losses.
Au ho summa y
Cance is a gene ic disease whe e changes in DNA cause al e a ions in he con ol o
cellula sys ems leading o unchecked g ow h. Copy numbe changes, including dupli-
ca ions, ampli ica ions, and dele ions, a e a common ype o DNA change obse ed in
cance cells bu i is no always clea which o he changes a e impo an in d i ing can-
ce de elopmen . We ha e examined his class o gene ic al e a ion in p os a e cance
by DNA sequencing he whole genome in 103 cance s. 64 ecu en copy numbe
changes we e de ec ed, o which 28 we e new. Fo gene ic losses ou s udy comp ehen-
si ely assessed he ole o a model called he “Knudson wo-hi gene ic model” whe e
al e a ions in bo h alleles o a gene is equi ed o gene a e unc ional al e a ions. This
model was only suppo ed a mino p opo ion o ecu en dele ions (15/40). This
obse a ion indica es ha o he mechanisms, such haploinsu iciency and epigene ic
inac i a ion, may accoun o he majo i y o dele ions. Ou s udies highligh se e al
no el changes including hose in non-coding lincRNA sequences, he iden i ica ion
ZNF292as a a ge gene o a ecu en dele ion on ch omosome 6, and he common
Knudson dele ions a he NKX3.1loci on ch omosome 8.
In oduc ion
Soma ic copy-numbe al e a ions (SCNAs) occu e y equen ly in human cance and exac ly
how hese al e a ions con ibu e o cance de elopmen is a subjec o conside able in e es .
App aising he ele ance o copy numbe loss and gain in p os a e
PLOS Gene ics | h ps://doi.o g/10.1371/jou nal.pgen.1007001 Sep embe 25, 2017 2 / 28
Ma sden NHS Founda ion T us and he p ojec
"P os a e Cance : Mechanisms o P og ession and
T ea men (PROMPT)" [G0500966/75466]). We
hank he Wellcome T us , Bob Champion Cance
T us , The O chid Cance appeal, The RoseT ees
T us , The No h Wes Cance Resea ch Fund, Big
C, The King amily, and The Masonic Cha i able
Founda ion o unding. This esea ch is suppo ed
by he F ancis C ick Ins i u e which ecei es i s
co e unding om Cance Resea ch UK
(FC001202), he UK Medical Resea ch Council
(FC001202), and he Wellcome T us (FC001202).
The unde s had no ole in s udy design, da a
collec ion and analysis, decision o publish, o
p epa a ion o he manusc ip .
Compe ing in e es s: I ha e ead he jou nal’s
policy and he au ho s o his manusc ip ha e he
ollowing compe ing in e es s: RE has ecei ed
educa ional g an s om Illumina and GenP obe
( o me ly Tepnel), Vis a Diagnos ics and Janssen
Pha maceu icals, as well as hono a ia om Succin
Communica ions o alks on p os a e cance
gene ics.
Mapping o SCNAs has iden i ied ecu en si es o al e a ions in many cance ypes, bu only
a small p opo ion o such si es ha e unambiguously been assigned o speci ic cance genes
[1].
Se e al models based on clonal e olu ion and selec ion may be in oked o explain ecu en
egions o ch omosomal loss in he au osomes and sex ch omosomes. In he classic model o
cance de elopmen p oposed by Knudson [2], mu a ions a e equi ed in each o he wo cop-
ies o a single gene: he loss o an allele is conside ed as one mu a ion and he emaining allele
would be al e ed by loss (homozygous dele ion), mu a ion o ea angemen . This is due o
s ong posi i e selec i e p essu e o al e a ion o bo h alleles. In p inciple, inac i a ion o he
emaining allele migh also in ol e epigene ic inac i a ion h ough DNA me hyla ion. Hap-
loinsu iciency is also an es ablished mechanism o cance de elopmen , whe e loss o only a
single allele is equi ed o cance de elopmen ; exp ession o he no mal allele is e ained in
he cance , albei a a lowe le el. This model is suppo ed in p os a e cance by ansgenic
mouse s udies o NKX3.1and p27
Kip1
[3,4].
Solimini e al. [5] ha e p o ided a model, whe e he collec i e con ibu ion o many genes
may p o ide selec i e ad an age o a cance cell, possibly o e lapping wi h he Knudson
model. De e al. and Fudenbe g e al. ha e p oposed a model whe e 3D ch oma in o ganiza ion
and spa ial co-localiza ion o DNA egions du ing eplica ion may explain he gene a ion o
copy numbe al e a ions [6,7]. Ano he explana ion is ha al e a ions a e simply he hallma k
o an uns able genome and ha e no pa icula unc ional signi icance, o example e lec ing
agile genomic si es. Simila conside a ion can be gi en o egions o gene ic gain and ampli i-
ca ion whe e o e exp ession o one o mo e genes is belie ed in many cases o d i e cance
de elopmen [8].
P os a e cance is he second mos common cance in men wo ldwide and in 2012 an es i-
ma ed 307,000 men died om p os a e cance wo ldwide [9]. Se e al s udies ha e in es iga ed
SCNA in p os a e cance [10–12], and c i ically, i has been es ablished ha he bu den o SCNA
is associa ed wi h subsequen biochemical ecu ence ( ising P os a e Speci ic An igen, PSA, le -
els a e adical p os a ec omy) and me as asis independen o ini ial PSA le els and Gleason
sco es. Simila obse a ions we e epo ed in a ecen s udy whe e a 100-loci (276 genes) copy
numbe signa u e was p edic i e o biochemical ecu ence [13]. Howe e , only a small p opo -
ion o he gains and losses ha e been unambiguously assigned o speci ic d i ing genes.
The cu en s udy is he i s o implemen a a ge ed app oach in p os a e cance whe e
Whole Genome DNA Sequencing (WGS) da a is used o comp ehensi ely examine mu a ion
da a in ela ion o he p esence o SCNAs. We used WGS da a om each pa ien o sc een
ecu en SCNA egions o po en ially unc ional al e a ions no only in p o ein coding
genes, bu also in genomic egions encoding lincRNAs, in con ol egions, and in o he con-
se ed DNA sequences. Unde s anding mechanisms o SCNA gene a ion and he iden i ica-
ion o a ge genes, linked o clinical ou comes, may assis in iden i ying no el bioma ke s
and he apeu ic a ge s.
Resul s
Genome wide copy numbe p o iles
ASCAT 2.2 [14,15] was used o iden i y soma ic copy numbe al e a ions (SCNAs; S2 Table;
ypes o al e a ion de ined in S1 Table) in WGS da a o malignan samples aken om 103
p os a e cance pa ien s (S2 Table). In cases o pa ien s wi h mul iple umo samples a single
p o ile was used. The ela ionship be ween samples wi hin a pa ien and he umou e olu ion
o he 13 pa ien s whe e he e we e mul iple umou samples has been p e iously in es iga ed
[16,17]. ETS gene s a us was in e ed om WGS da a (S3 Table).
App aising he ele ance o copy numbe loss and gain in p os a e
PLOS Gene ics | h ps://doi.o g/10.1371/jou nal.pgen.1007001 Sep embe 25, 2017 3 / 28
When compa ed o p os a ec omy cases, me as a ic cance s had highe p opo ions o e -
aploid genomes as de ined by ASCAT (53% s 19%; Fishe ’s exac es , p= 0.0042; S4 Table),
signi ican ly la ge numbe s o SCNAs (mean 83 s 21; Mann-Whi ney U p = 2.17x10
-08
),
highe copy numbe bu den (pe cen age o he genome al e ed) (mean 31.24% s 7.694%;
Mann-Whi ney U p = 1.30x10
-08
), and longe a e age SCNA size (Mann-Whi ney U p =
4.37x10
-04
). Pa ien s wi h mo e han 44 SCNAS ( he mean numbe o SCNAs in pa ien s ha
had p og essed wi hin six mon hs) had wo se p ognosis (Log- ank es p= 0.027, median ol-
low up o 16.5 mon h; Fig 1A and 1B) han pa ien s wi h ewe SCNAs, consis en wi h o he
publica ions [13,18,19] linking highe numbe s o SCNAs o poo e ou come. Pa ien s wi h
highe copy numbe bu den had wo se p ognosis (Log- ank es p= 0.023; Fig 1C and 1D).
Classi ica ion o p os a e cance based on copy numbe p o iles
Hie a chical clus e ing analysis was applied on o e lapping SCNAs p esen in a leas i e
pa ien s. A bina y ma ix was cons uc ed on he basis o a pa ien ha ing a egion o ampli ica-
ion o dele ion (1) o no (0). Fi e majo clus e s we e obse ed: C1-C5 (Fig 2;S5 Table). C5
and C4 we e composed mainly o me as a ic cases (6/13 and 5/7) while he emaining me as a ic
cases we e placed in C2 (3/39) and C3 (2/16). Pa ien s in C1 had ewe SCNAs han hose in
C2-C5 (mean 6.79 s 40.32 SCNAs) and lowe copy numbe bu den (mean 1.64% s 14.98%).
P os a ec omy/TURP pa ien s in C1 had no signi ican di e ence in Gleason Sco es (X
2
es
p= 0.213; Fig 3A) o in hei le els o PSA a diagnosis (Mann-Whi ney U p = 0.929). P os a ec-
omy pa ien s in C1 had a signi ican ly be e p ognosis (Log- ank es p= 0.028; Fig 3B).
De ec ing egions o ecu en al e a ion
We de ined a ecu en egion o al e a ion as he minimal egion o o e lap ha con ains
suppo ing al e a ions om i e o mo e pa ien s (minimal MRA, Fig 4A). 40 egions o dele-
ion and 24 egions o gain we e iden i ied (S6 Table). To iden i y po en ial d i e genes, we
Fig 1. Soma ic copy numbe al e a ions in 103 pa ien s. (A) Soma ic copy numbe al e a ions in elapse ee (n = 59) and p og essed pa ien s
(n = 10) a e adical p os a ec omy a six mon hs and (B) associa ion wi h ime o biochemical ecu ence ( he wo g oups we e de ined ela i e o he
mean numbe o SCNAs in p og essed pa ien s (44 SCNAs) wi hin he coho ). P og essed pa ien s had signi ican ly mo e SCNAs han elapse ee
pa ien s (a mean o 19 compa ed o 44; Mann-Whi ney U p = 0.0133). (C) Copy numbe bu den in elapse ee and p og essed pa ien s a e adical
p os a ec omy a six mon hs and (D) associa ion wi h ime o biochemical ecu ence ( he wo g oups we e de ined ela i e o he mean copy numbe
bu den in p og essed pa ien s wi hin he coho ). P og essed pa ien s had lowe copy numbe bu den (mean o 7.359 compa ed o a mean o 11.710;
Mann-Whi ney U p = 0.0166).
h ps://doi.o g/10.1371/jou nal.pgen.1007001.g001
App aising he ele ance o copy numbe loss and gain in p os a e
PLOS Gene ics | h ps://doi.o g/10.1371/jou nal.pgen.1007001 Sep embe 25, 2017 4 / 28
sc eened sequencing da a o de e mine whe he each MRA con ained poin subs i u ions,
inse ions and/o dele ions wi hin he coding egion o genes (Table 1,S7 Table), in cance -
ela ed and conse ed lincRNAs om MiT ansc ip ome [20] (S8 Table), in p omo e egions
(S9 Table) and in DNA High-occupancy a ge (HOT) egions [21] (S10 Table). To educe he
e ec o ou lie measu emen s in ou da a, when sc eening o mu a ions we used a la ge
minimal common egion o al e a ion, e e ed o as he ex ended MRA, which is de ined by
emo ing he wo al e a ions ha we e closes o he 5’ bounda y o he minimal MRA and
simila ly he wo al e a ions closes o he 3’ bounda y (S1 Fig,S6 Table). We also applied he
s a is ical me hod GISTIC [22] o de ine signi ican egions o gain and loss (15 gains and 19
losses, esidual q<0.05, S11 Table). 14 losses and one gain we e common o ou lis o mini-
mal MRAs and 5 losses and 14 gains we e only de ec ed by GISTIC (S6 Table). 16 ou o 34 sig-
ni ican GISTIC egions ( esidual q<0.05) we e also de ec ed in o he p os a e cance s udies
ha applied GISTIC [23,24], only ou o which we e no de ec ed by ou app oach.
Fig 2. Clus e dendog am and hea map o soma ic copy numbe al e a ions in 103 pa ien s. Clus e dendog am and hea map o ampli ica ions ( ed)
and dele ions (blue) ep esen ing he soma ic copy numbe p o ile o he 103 pa ien s calcula ed using unsupe ised hie a chical clus e ing wi h Manha an
dis ance and comple e in e -clus e linkage. Samples wi h SNP6.0 da a a e indica ed wi h an as e isk. Con idence in e als de e mined by mul iscale
boo s ap esampling a e displayed in S2 Fig.
h ps://doi.o g/10.1371/jou nal.pgen.1007001.g002
App aising he ele ance o copy numbe loss and gain in p os a e
PLOS Gene ics | h ps://doi.o g/10.1371/jou nal.pgen.1007001 Sep embe 25, 2017 5 / 28

Known egions o gene ic al e a ion
The mos equen MRAs we e loca ed a 8p21.3-p21.2 (60% loss), 6q15 (49%), 13q14.13
(46%) and 10q23.31 (39%), in ag eemen wi h p e ious s udies [18,24–26] (Fig 5,S3 Fig).
8p21.3-p21.2 is an example o a loss whe e haploinsu iciency has been p oposed as he p i-
ma y mechanism. The minimal MRA con ains 16 coding genes, including NKX3.1, a sugges ed
a ge gene o his egion [24,25] (Fig 5B). The lincRNA KCCAT306 (MiT ansc ip iome ID)
was he only sequence mu a ed mo e han once (S8 Table). NKX3.1was howe e , a ec ed by a
homozygous dele ion in h ee pa ien s (S12 Table). 1.1MBp om he minimal MRA he e is a
egion a ec ed by homozygous loss in i e pa ien s con aining PPP2R2a,EBF2,BNIP3L,
PNMA2 and DPYSL2.BNIP3L, which coun e ac s he apop o ic induce BNIP3, is ano he
p oposed a ge [26].
By compa ison, 10q23.31 p o ided an example whe e al e a ions in bo h alleles a e
obse ed, consis en wi h he Knudson wo-hi model [2], wi h PTEN as he a ge . A high p o-
po ion o he dele ions we e homozygous losses (11/39, S12 Table,Fig 5C). In se en cases
when one allele was dele ed, a mu a ion was ound a he emaining PTEN allele (Table 1).
PTEN al e a ions we e mo e common in me as a ic disease han in he p os a ec omy se ies
(93% s 29%; Fishe ’s exac es , p= 1.0x10
-08
). Consis en wi h p e ious s udies [27,28], some-
imes only he 5’ end o he PTEN gene was los . 17p13.1 (35%) is ano he example o his class
(S2T Fig,Table 1) whe e TP53 was a ec ed by mu a ion in nine pa ien s who all had an associ-
a ed SCNA and homozygous loss was seen in wo pa ien s.
MAP3K7, a p oposed a ge o he 6q14.3-q15 dele ion [25,26] is loca ed 2.4Mbp away
om he ex ended MRA (Fig 5A). ZNF292was mu a ed on he emaining allele in one pa ien
and has been ound o be ea anged in p os a e cance [29]. The lincRNAs KHCAT274 and
KHCAT370 (MiT ansc ip iome IDs) in he ex ended MRA we e mu a ed ou imes on he
allele ha emained a e dele ion (Fig 5A,S8 Table). The known dele ion a 17q21.31
[18,23,26] (Fig 5F) had a minimal MRA ha con ained UBTF, a known usion pa ne o
ETV4[30].
Fig 3. Clus e associa ions wi h clinical ac o s. (A) Clus e s associa ion wi h Gleason Sco e (p os a ec omies and TURP samples only). (B)
Clus e s associa ion o isk o biochemical ecu ence wi hin C1 and C2-C5. A he ime o w i ing he single p os a ec omy case in C5 had a ollow
up ime o 23 mon hs and had no p og essed.
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Fig 4. F equency plo ep esen ing egions o ampli ica ion ( ed) and dele ion (blue). Ac oss samples om (A) all 103 pa ien s, (B) ETS-
posi i e cance s, and (C) ETS-nega i e cance s. SCNAs p esen in mo e han one pa ien we e plo ed. The g een lines ep esen he cu -o (5
pa ien s) o de ining ecu en ly al e ed egions. Ch omosome numbe s a e indica ed in black. Genes po en ially in ol ed in p os a e cance
de elopmen in he minimal egions o al e a ion a e anno a ed in black.
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RB1 and BRCA2 a e wo p oposed candida es o he MRA a Ch omosome 13q14.13 (Fig
5D) [18,25,26]. RB1 is loca ed 1.3MBp om he minimal MRA and wi hin he ex ended MRA.
In h ee pa ien s, a egion o homozygous loss spans RB1 (S12 Table). BRCA2 was 9.5MBp ou -
side he ex ended MRA.
Dele ions con aining only one gene in he minimal MRA, we e de ec ed a 3p13 con aining
RYBP (33.01%, S2D Fig), 12p13.1 con aining CDKN1B(27.18%, S2N Fig), and 14q24.1 con-
aining RAD51B(10.68%, Fig 5E) bu none had mu a ions in he emaining allele (Table 1,S6
Table).
Gains a Ch 8q exhibi ed a complex s uc u e wi h h ee b oad peaks (Fig 6A,S4 Fig). The
p oposed a ge o 8q24.21, MYC, was loca ed 48kb om he minimal MRA and was p esen
in he ex ended MRA. Thi een mu a ions we e ound in o al a PCAT1 and CCAT1 wi h
se en accompanying ch omosome gain (S8 Table). The ampli ica ion a 7p11.2, p esen in
11.65% o pa ien s, con ained EGFR in he minimal MRA (Fig 6B). The ex ended MRA egion
con ained a o al o se en mu a ions wi h he highes numbe in lincRNA CAT941. Ampli ica-
ion o 14q13.3-q21.1 (Fig 6C) con ained only FOXA1 and MIPOL1.
No el egions o ecu en gene ic al e a ion
24 addi ional no el ecu en egions o loss and gain we e de ec ed (S6 Table,S1 Appendix),
including egions o loss wi h mo e han 15% equency a 4p15.2-p15.1 (15.53%), 6q27
(16.50%) and 18q12.3 (17.48%). Regions o gain wi h he highes equencies we e a 1q25.3
(8.74%), 5p15.31 (9.71%), and 10q21.1-q21.3 (8.74%). Fo wo o hese egions, 22q12.1-q12.2
Table 1. Genes ha a e ecu en ly al e ed by coding-changing mu a ions in egions o ecu en soma ic copy numbe al e a ion de ined by he
ex ended MRAs.
Gene Gene name Numbe o
mu a ions
Pa ien s wi h a SCNA
and mu a ion
Pa ien s wi h
SCNA (%)
Type o
SCNA
FOXA1 (14q21.1) Fo khead box p o ein A1 11 1 6 (5.83) Amp
TP53 (17p13.1) Tumo p o ein p53 9 9 37 (35.92) Del
PTEN (10q23.31) Phospha ase and ensin homolog 9 7 39 (37.86) Del
HMCN1 (1q25.3) Hemicen in-1 6 1 8 (7.77) Amp
KIF26B (1q44) Kinesin amily membe 26B 4 2 7 (6.80) Amp
KIAA1614 (1q25.3) Uncha ac e ized P o ein KIAA1614 4 1 8 (7.77) Amp
TCF12 (15q21.3) T ansc ip ion ac o 12 3 1 15 (14.56) Del
CACNA1E (1q25.3) Calcium channel, ol age-dependen , R ype,
alpha 1E subuni
3 1 8 (7.77) Amp
PHYKPL/AGXT2L2
(5q35.3)
5-Phosphohyd oxy-L-lysine phospho-lyase 3 0 8 (7.77) Amp
SCN4A (17q23.3) Sodium channel p o ein ype 4 subuni alpha 3 0 4 (3.88) Amp
C17o 58 (17q24.2) Ch omosome 17 open eading ame 58 3 0 4 (3.88) Amp
RYR2 (1q43) Ryanodine ecep o 2 3 0 12 (11.65) Amp
ZFHX4 (8q21.11) Zinc inge homeobox 4 2 2 31 (30.10) Amp
TRPA1 (8q13.3) T ansien ecep o po en ial ca ion channel,
sub amily A, membe 1
2 2 31 (30.10) Amp
NBN/NBS1 (8q21.3) Nib in 2 2 32 (31.07) Amp
COL27A1 (9q32) Collagen, ype XXVII, alpha 1 2 1 5 (4.85) Amp
AMBP (9q32) Alpha-1-mic oglobulin/Bikunin p ecu so 2 1 5 (4.85) Amp
UIMC1 (5q35.2) Ubiqui in in e ac ion mo i con aining 1 2 1 6 (5.83) Amp
SLC26A2 (5q32) Solu e ca ie amily 26 (anion exchange ),
membe 2
2 1 8 (7.77) Amp
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Fig 5. Examples o minimal ecu en dele ions. Dele ions a (A) 6q14.3-q15, (B) 8p21.3-p21.2, (C)
10q23.31, (D) 13q14.13, (E) 14q24.1 and (F) 17q21.31. The genomic loca ion o he MRA and linked genes
a e displayed. Fo he loss a 8p a ecu en egion o homozygous loss (8:25417422–26386565) close o he
MRA is indica ed.
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Me hods
Sample coho
141 malignan samples om 105 pa ien s wi h p os a e cance wi hin he Cance Resea ch UK
ICGC P os a e Cance P ojec we e included in his s udy: 88 cance s collec ed a e adical
p os a ec omy, including 10 umo and h ee blood samples om h ee men wi h complex o
mul i ocal disease; i e cance s om men diagnosed wi h p os a e cance in Shanghai; wo
cance s collec ed om ansu e h al esec ion o he p os a e (TURP); 8 lymph node me a-
s a ic samples om non-and ogen dep i ed pa ien s; and 36 malignan samples om 7 men
wi h me as a ic disease belonging o he PELICAN apid au opsy p og am [17]. Samples we e
collec ed subjec o ICGC s anda ds o e hical consen . E hical app o al o his wo k was
ob ained om he espec i e local e hics commi ees (NHS Sou h Wes London REC [10/
H0806/113]; NHS Eas Midlands–De by REC [01/4/061]; NHS Eas o England—Camb idge
REC [03/018]; John Hopkins IRB [NA_00003925]; Changhai Hospi al E hics commi ee; Join
Chinese Uni e si y o Hong Kong-New Te i o ies Eas Clus e Clinical Resea ch E hics Com-
mi ee [CRE-2011.373]) and om The T en Mul icen e Resea ch E hics Commi ee [MREC/
01/4/061]. Explici in o med w i en consen was ob ained om all pa icipan s o he use and
s o age o hei gene ic ma e ial and issue samples in esea ch, including whole genome
sequencing. Explici w i en consen was also ob ained o any da a de i ed om hese sam-
ples, along wi h coded clinical/heal h da a, o be placed on an in e na ional da abase (ICGC)
and made a ailable o ICGC membe s and o he in e na ional esea che s unde open o con-
olled access. P os a ec omy samples we e collec ed as desc ibed p e iously [65]. Blood sam-
ples we e used as no mal con ols excep o PELICAN samples whe e no mal issue was used.
DNA p epa a ion and DNA sequencing
DNA om whole blood samples and ozen issue was ex ac ed and quan i ied using a ds-
DNA assay (UK-Quan -iT PicoG een dsDNA Assay Ki o DNA) ollowing manu ac u e ’s
ins uc ions wi h a Fluo escence Mic opla e Reade (Bio ek Syne gyHT, Bio ek). Accep able
DNA had a concen a ion o a leas 50ng/μl in TE (10mM T is/1mM EDTA), wi h an OD
260/280 be ween 1.8–2.0. Fo aCGH a leas 10μl equi alen o 500ng we e used o hyb idisa-
ion o he A yme ix SNP6.0 a ay. WGS was pe o med a Illumina, Inc. (Illumina Sequenc-
ing Facili y, San Diego, CA USA) o he BGI (Beijing Genome Ins i u e, Hong Kong) as
desc ibed p e iously o a a ge dep h o 50X o he umo samples and 30X o ma ched con-
ols [66]. The Bu ows-Wheele Aligne (BWA) was used o align he sequencing da a o he
GRCh37 human genome [66].
Gene a ion o segmen ed copy numbe p o iles
Pseudo-SNP6.0 p o iles we e c ea ed o each umo and ma ched con ol om whole genome
sequencing da a. In a small numbe o cases da a was ob ained di ec ly om A yme ix
SNP6.0 a ays (S18 Table) and escaled and ans o med using PennCNV [67]. ASCAT 2.2
was hen used o gene a e segmen ed copy numbe p o iles and es ima e he pu i y and ploidy
o he sample using a penal y o 50 and gamma alue o 1 [14,15]. No e ha gi en he a ge
sequencing co e age o 50x/30x, he e may be s ochas ic egions o low co e age whe e ue
segmen s a e no de ec ed. Two p os a ec omy samples wi h low es ima ed umo con en
we e emo ed om u he analysis. Da a om he ma ched con ol is used o educe alse
posi i es. A conse a i e il e ing s a egy was used o ensu e he bes quali y o segmen s a e
ob ained and gi e us he g ea es con idence in he minimal egions o al e a ion ha we call.
App aising he ele ance o copy numbe loss and gain in p os a e
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8876 segmen s we e emo ed, o which 6692 we e emo ed based on he ollowing il e ing
c i e ia:
• Segmen was wi hin cen ome ic o elome ic egions (ex ended by 1,000,000 bp).
• Segmen was wi hin low mapabili y egions as de ined by ENCODE (ex ended by 1,000,000
bp).
• Segmen copy numbe o majo allele (nMajo ) >25 and copy numbe o majo allele
(nMino ) = = 0, o nMajo >= 10 and leng h was less han 500,000bp.
• Segmen whe e he mino allele copy numbe is la ge han he majo allele copy numbe .
• Segmen had less han 50 suppo ing SNPs and leng h was less han 100,000bp
The emaining 2184 segmen s we e il e ed ou upon isual inspec ion in a blind ashion.
Visual inspec ion included checking ha he change in copy numbe was in ag eemen wi h
he o e all ploidy o he sample, ha he e was a change in BAF and o al copy numbe , and
ha he SNPs wi hin he segmen didn’ ha e high a iance. In he majo i y o cases segmen s
we e emo ed because ASCAT did no ge he app op ia e i and he e was no ob ious copy
numbe change. In his and o he ICGC p ojec s we ha e gene ally ound ha isual inspec-
ion o any class o al e a ion is an excellen me hod o il e ing ou inco ec calls made by
he algo i hms. Simila esul s we e ob ained om SNP6.0 and pseudo-SNP6.0 p o iles (S6
Fig). We also applied he s a is ical me hod GISTIC 2.0.16 [22] o de ine signi ican egions o
gain and loss, using he de aul pa ame e s. No e ha all p e- il e ed segmen s we e used when
he GISTIC algo i hm was applied.
Con e sion o sequencing da a o a pseudo-SNP6.0 p o ile
The numbe o eads o each nucleo ide base a each p obe posi ion on he A yme ix
SNP6.0 na32 hg19 anno a ion was ex ac ed om sequence using deepSNV [68]. The loga-
i hm o he a io (LogR) be ween allele A and B and he B allele equency (BAF) we e calcu-
la ed as ollows:
LogRi¼log2ðAiþBiÞ
BAF ¼Bi
ðAiþBiÞ
whe e A
i
is he ead coun o allele A o p obe iand B
i
is he ead coun o allele B. Fo CN
p obes:
LogRi¼log2ðNiÞ
whe e N
i
is he o al numbe o eads a he posi ion o p obe i. The LogR alues we e no mal-
ised:
LogRi¼LogRimedianðLogRÞ
SNP p obes wi h no eads a A and B alleles o wi h a BAF o 1 o 0 we e emo ed. Using he
SNP6 a ay p obe posi ions o WGS da a wi h ASCAT is a common app oach, used success-
ully in he ICGC pancance analysis o whole genomes p ojec (h ps://dcc.icgc.o g/pcawg)
[69]. A w appe p og am o ease o use is a ailable [70].
App aising he ele ance o copy numbe loss and gain in p os a e
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Calcula ion o he minimal egions o al e a ion (MRA)
Da a om pa ien s wi h mul iple umo samples is collapsed in o one copy numbe p o ile pe
pa ien using all de ec ed egions. O e lapping egions o SCNAs we e iden i ied ac oss all
pa ien s by applying he GenomicRanges co e age unc ion [71]; ampli ica ions and dele ions
we e analysed independen ly. The minimal MRA is de ined by iden i ying he egion mos e-
quen ly al e ed in each peak egion o o e lap be ween i e o mo e pa ien s. This is an a bi-
a y h eshold, bu simpli ying segmen calling o a andom p ocess and assuming ha a copy
numbe will be called in a egion 1% o he ime by chance (which we would conside high),
hen gi en i e pa ien s, i is signi ican ly likely ha he ue numbe o segmen s is g ea e
han 1% (p= 0.0039; Exac binomial es ). The ex ended MRA expands he minimal MRA by
aking he s a posi ion o he o e lapping segmen wi h he hi d la ges s a posi ion and
he end posi ion o he segmen wi h he hi d smalles end posi ion (S1 Fig).
Mu a ional sc een
Subs i u ions, inse ions and dele ions we e de ec ed using he Cance Genome P ojec Well-
come T us Sange Ins i u e pipeline. An upda ed e sion o his pipeline is a ailable as a Docke
image (Alignmen : h ps://docks o e.o g/con aine s/quay.io/w sicgp/docks o e-cgpmap; Va i-
an -calling: h ps://docks o e.o g/con aine s/quay.io/w sicgp/docks o e-cgpwgs). The Bu ows-
Wheele Aligne ’s Smi h-Wa e man Alignmen (BWA-SW) 0.5.9- 16+ ugo was used o align
he sequencing da a om each lane o he GRCh37 e e ence human genome using pa ame e s
-l 32 - 6 [72]. Lanes ha pass quali y con ol a e me ged in o a single well-anno a ed sample
BAM ile wi h PCR duplica e eads emo ed. Subs i u ions we e de ec ed using CaVEMan 1.3,
an in-house bespoke algo i hm de eloped a he Sange Ins i u e (h p://cance i .gi hub.io/
CaVEMan/), wi h a cu -o ‘soma ic’ p obabili y o 95%. CaVEMan u ilises a Bayesian expec a-
ion maximiza ion (EM) algo i hm: Gi en he e e ence base, copy numbe s a us and ac ion
o abe an umo cells p esen in each cance sample, CaVEMan gene a es a p obabili y sco e
o po en ial geno ypes a each genomic posi ion. Fu he pos -p ocessing il e s we e applied o
elimina e alse posi i e calls a ising om genomic ea u es ha gene a e mapping e o s and sys-
ema ic sequencing a i ac s. In compa isons wi h o he mu a ion calle s i has been ound o be
amongs he op pe o me s in e ms o sensi i i y and speci ici y [73]. Only subs i u ions ha
we e a missense, nonsense, s a -los , o occu ed in a non-coding ansc ip we e conside ed.
Inse ions and dele ions we e called using a ligh ly modi ied e sion o pindel 4.2 [74] (h p://
cance i .gi hub.io/cgpPindel/). Only indels ha we e in ame, ameshi , o occu ed in a non-
coding ansc ip we e conside ed. S uc u al a ian s we e de ec ed using B ass (B eakpoin s
ia assembly) 1.0.3, an in-house bespoke algo i hm de eloped a he Sange Ins i u e (h ps://
gi hub.com/cance i /BRASS). In b ie , he i s s ep is o combine disco dan ead pai s in o
po en ial egions whe e a b eakpoin migh occu . Nex , eads a ound each po en ial egion,
including hal -unmapped eads, a e ga he ed and a local de no o assembly using Vel e is pe -
o med [75]. By analysing he De B uijn g aph pa e n he b eakpoin can be iden i ied down o
base pai esolu ion. Any b eakpoin s whe e an exac loca ion could no be de e mined we e
emo ed. A posi i e ETS s a us was assigned i a b eakpoin be ween ERG,ETV1 o ETV4 and
p e iously epo ed pa ne DNA sequences [76] we e de ec ed. Genes in each MRA we e iden-
i ied using good quali y ansc ip s anno a ed in he EnsEMBL Genome Re e ence Conso ium
Human Build 37.p13 (GRCh37.p13).
The mu a ional sc een o homozygous loss was pe o med in any egion ha had a homozy-
gous loss in a leas one sample. Fo mu a ions ha occu wi hin p omo e s, EPDNew human
e sion 003 [77] was used o de ine p omo e egions. Conse ed egions o DNA we e de e -
mined om UCSC phas Cons sco es o mul iple alignmen s o 45 e eb a e genomes o he
App aising he ele ance o copy numbe loss and gain in p os a e
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hg19 human genome using a h eshold p- alue o 0.95. We used 7,942 long noncoding RNAs
(lincRNAs) om he MiT ansc ip ome p ojec ha we e de ec ed in 7,256 RNA sequencing
lib a ies om umo s, no mal issues and cell lines and de ined as being ei he cance -associ-
a ed o con aining conse ed egions [20].
S a is ical es s and su i al analyses
All s a is ical es s we e pe o med in R [78]. Fo compa isons be ween g oups he non-
pa ame ic Mann-Whi ney U es was used o con inuous a iables and he X
2
es wi h
Ya es’ con inui y co ec ion o Fishe ’s exac es was used o ca ego ical a iables. Fo all
s a is ical es s used he e is he assump ion o independence be ween da a and we ha e
ensu ed his is he case by only using one copy numbe p o ile pe pa ien in all compa i-
sons. The sample used o he copy numbe p o ile was chosen a andom (see S2 Table o
selec ion). In all cases whe e he X
2
es was applied no cells in he con ingency able had an
expec ed alue less han 5.
Clinical associa ions we e de e mined using s anda d s a is ical es s wi h Benjamin-Hoch-
be g mul iple es ing co ec ion applied. The log- ank es was used o pe o m su i al analy-
ses wi h biochemical ecu ence a e p os a ec omy as he end poin o su i al analyses.
Reasonable assump ions we e made i.e. censo ing is un ela ed o p og ess, su i al p obabili-
ies a e he same o subjec s ec ui ed ea ly and la e in he s udy, and e en s happen a he
imes speci ied. 84 ou o 86 p os a ec omy pa ien s we e used; wo pa ien s had incomple e
clinical da a (0040 and 0052). Fo he pa ien s whe e da a was a ailable om mul iple samples,
he pa ien was classi ied as ha ing he minimal egion o al e a ion i i occu ed in any o he
samples.
Pa hway analysis
The en ichmen analysis was pe o med by explo ing he Reac ome canonical pa hways using
he Reac ome plugin in Cy oscape [79] using he genes con ained wi hin he ex ended MRAs.
In eg a ion o Reac ome and Kyo o Encyclopaedia o Genes and Genomes (KEGG) canonical
pa hways pa hway analysis [80] was used o cons uc a map o he majo pa hways al e ed in
p os a e cance wi hin ou coho .
Iden i ying genes a ec ed by ea angemen s
Rea angemen b eakpoin s wi hin he ex ended MRA and wi hin he signi ican GISTIC
egions (q- alue <= 0.05) we e selec ed and used o de ine associa ed gene allele-speci ic
e en s. Dele ions ha had common egions de ec ed by ASCAT2.2 and B ass o by ASC
AT2.2 only we e included in he analysis. A gene was de ined as being a ec ed by a ea -
angemen , and hence a bi-allelic e en , i an inse ion, in e sion o in a-ch omosomal
b eakpoin occu ed wi hin he gene egion o he gene occu ed wi hin an in e sion. I
a gene was in e ed wice and he b eakpoin s o he ea angemen we e ou side he gene
coo dina es i was assumed he gene was s ill unc ional; hese e en in e sions we e e-
mo ed om he analysis.
Da a access
Sequencing da a has been deposi ed a he Eu opean Genome-phenome A chi e
(EGAS00001000262, S1 Table).
App aising he ele ance o copy numbe loss and gain in p os a e
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Suppo ing in o ma ion
S1 Fig. Diag amma ic explana ion on minimal and ex ended MRA.
(PDF)
S2 Fig. Hie a chical clus e ing o 103 p os a e cance samples wi h mul iscale boo s ap
esampling. The da a a e bina y alues co esponding o he p esence/absence (1/0) o egions
o copy numbe gain and loss in each o he umou samples. p- alues we e calcula ed ia hie -
a chical clus e analysis wi h mul iscale boo s ap esampling o 1000 using Wa d’s me hod
and he Manha an dis ance. The analysis was pe o med using he p clus package in R. Val-
ues a b anches a e AU (App oxima ely Unbiased) p- alues (le , ed), and BP (Boo s ap
P obabili y) alues ( igh , g een). Clus e s signi ican ly suppo ed by he da a (AU 95) a e
indica ed by he ed ec angles.
(PDF)
S3 Fig. Copy numbe al e a ion segmen s de ec ed by ASCAT ha o e lap wi h dele ion
MRAs. Each dele ion is ep esen ed as a dis inc colou as shown in he key. Dele ions a e as
ollows: neu al LOH (loss o one allele wi h duplica ion o he emaining allele); hemizygous
dele ion LOH (loss o one allele); homozygous loss (loss o he wo alleles); and o he loss (loss
o one allele copy ollowing whole genome duplica ion). Cases o which mo e han one sam-
ple was a ailable a e all indica ed, howe e con ibu ion o he equency o he SCNA was
de ined on a pe pa ien basis. The egions o SCNA a e o de ed by leng h: op-smalles , bo -
om-la ges . Each block has been labelled wi h sample ID. (a) ch 1 p31.1, (b) ch 1 q42.2-q42.3,
(c) ch 2 q21.3-q22.1, (d) ch 3 p13, (e) ch 4 p15.2-p15.1, ( ) ch 4 q22.3, (g) ch 4 q27-q28.1, (h)
ch 4 q34.3, (i) ch 5 q13.1-q13.2, (j) ch 7 q31.32-q31.33, (k) ch 9 p22.3, (l) ch 11 p13, (m)
ch 11 q23.2, (n) ch 12 p13.1, (o) ch 12 q24.33, (p) ch 14 q24.1, (q) ch 14 q32.13, ( ) ch 15
q21.3, (s) ch 16 q23.1-q24.3, ( ) ch 17 p13.1, (u) ch 18 p11.32-p11.31, ( ) ch 18 q12.3, (w)
ch 18 q23-q22.3, (x) ch 19 p12, (y) ch 19 q13.31, (z) ch 20 p13, (a2) ch 20 p12.1, (b2) ch 20
q13.33, (c2) ch 21 q22.2, (d2) ch 21 q22.3, (e2) ch 22 q12.1-q12.2, ( 2) ch 22 q13.31, (g2)
Ch 6q14.3-q15, (h2) Ch 8p21.3-p21.2, (i2) Ch 10q23.31, (j2) Ch 13q14.13, (k 2) Ch 17q21.3,
(l2) Ch 5q21.1, (m2) Ch 6p25.1-p24.3, (n2) Ch 6q27.
(PDF)
S4 Fig. Copy numbe al e a ion segmen s de ec ed by ASCAT ha o e lap wi h ampli ica-
ion MRAs. The ch omosome gain e en s a e ep esen ed wi h dis inc colou blocks depending
on he ype o SCNA: gain (any gain in he numbe o no mal allele copies) and ampli ica ion
LOH (loss o one allele wi h any gain o he emaining allele). The egions o SCNA a e o de ed
by leng h: op-smalles , bo om-la ges . Each block has been labelled wi h sample ID. Cases o
which mo e han one sample was a ailable a e all indica ed, howe e con ibu ion o he e-
quency o he SCNA was de ined on a pe pa ien basis. (a) ch 1 q21.3-q22, (b) ch 1 q25.3, (c)
ch 1 q43-q44, (d) ch 2 q24.3, (e) ch 5 p15.31, ( ) ch 5 q33.3-q35.2, (g) ch 9 q33.1, (h) ch 10
q21.1-q21.3, (i) ch 11 q13.4-q13.5, (j) ch 11 q14.3, (k) ch 12 q23.1, (l) ch 13 q11-q12.11, (m)
ch 13 q33.3, (n) ch 13 q33.3-q34, (o) ch 14 q13.3-q21.1, (p) ch 16 p13.3, (q) ch 16 p13.3, ( )
ch 16 p13.12-p13.11, (s) ch 17 q22-q23.1, ( ) Ch 8q11.1-q11.21, (u) Ch 7p11.2, ( )
Ch 8q21.1-q12.1, (w) Ch 8q24.21, (x) Ch 3q22.1-q21.3.
(PDF)
S5 Fig. Commonly al e ed pa hways in ETS posi i e and nega i e cance s. Blue and ed
blocks indica e genes con ained in egions o dele ion and ampli ica ion espec i ely. G ey
blocks indica e genes wi h no al e a ion ha we e equi ed o ep esen a ion o he pa hway.
Pu ple and blue squa es indica e he pe cen age o samples wi h a copy numbe al e a ion in
App aising he ele ance o copy numbe loss and gain in p os a e
PLOS Gene ics | h ps://doi.o g/10.1371/jou nal.pgen.1007001 Sep embe 25, 2017 20 / 28
ha gene in ETS nega i e and posi i e samples.
(PDF)
S6 Fig. A pla o m compa ison o ASCAT p o iles on a single sample. (a) one p o ile om
SNP6.0 and (b) one om NGS da a.
(PDF)
S1 Table. Classi ica ion o soma ic copy numbe al e a ions.
(DOCX)
S2 Table. Copy numbe p o iling o 103 pa ien s. Including ploidy, deg ee o con amina ion
and numbe o SCNAs. Clinico-pa hological cha ac e is ics o he s udy coho consis ing o
105 pa ien s. In o ma ion on pa ien s unde going adical p os a ec omy (88) and TURP (2) is
displayed.
(XLSX)
S3 Table. ETS gene s a us.
(XLSX)
S4 Table. Summa y cha ac e is ics o he genomes and soma ic copy numbe al e a ions
(SCNAs). Le side: Samples classi ied by disease s a us i.e. samples om p os a ec omies om
pa ien s ee o me as a ic disease (PT) o samples om pa ien s wi h me as a ic disease (M).
Righ side: P os a ec omy samples whe e he e was a leas six mon hs ollow up (n = 69) classi-
ied by whe he he e was apid biochemical ecu ence wi hin six mon hs o p os a ec omy
(PG) o no (RF) ( igh side). The wo TURP samples a e no summa ized in his able. Resul s
om s a is ical es s a e shown ha es whe he he e a e signi ican di e ences be ween
ei he me as a ic and p os a ec omy pa ien s o p os a ec omy pa ien s ha ha e biochemical
ecu ence wi hin six mon hs o no .
(DOCX)
S5 Table. Summa y o clinico-pa hological cha ac e is ics o he pa ien s in he de ined
se s o clus e s.
(DOCX)
S6 Table. Minimal egions o dele ions and ampli ica ions wi h linked genes. This able
includes: Compa ison o MRAs, ex ended MRAs and GISTIC-de ec ed egions; ampli ica ions
and dele ions ound in p e ious p os a e cance s udies.; pe cen age o he minimal egions o
al e a ions ha a e conse ed egions; and clinical co ela ions and ETS associa ions o mini-
mal egions o soma ic copy numbe al e a ion.
(XLSX)
S7 Table. Genes wi h mu a ions in ex ended MRA, GISTIC, and homozygous loss egions.
Possible haploinsu iciency a ge s a e iden i ied as genes whe e he e a e a leas h ee mu a-
ions and a no mal allele e ained.
(XLSX)
S8 Table. Mu a ions in lncRNAs and conse ed RNAs loca ed wi hin he minimal egions
o soma ic copy numbe al e a ion. lncRNAs we e examined ha we e de ined by he
MiT ansc ip ome p ojec as being ei he cance -associa ed o con aining conse ed egions.
(XLSX)
S9 Table. Mu a ions in p omo e egions o genes wi hin he minimal egions o
al e a ion.
(DOCX)
App aising he ele ance o copy numbe loss and gain in p os a e
PLOS Gene ics | h ps://doi.o g/10.1371/jou nal.pgen.1007001 Sep embe 25, 2017 21 / 28

S10 Table. Mu a ions in DNA High-occupancy a ge (HOT) egions.
(XLSX)
S11 Table. GISTIC egions o dele ion and ampli ica ion. q- alues: The q- alue o he peak
egion. Residual q- alues: The q- alue o he peak egion a e emo ing (“peeling o ”) ampli-
ica ions o dele ions ha o e lap o he , mo e signi ican peak egions in he same ch omo-
some. Wide Peak Limi s: The “wide peak” bounda ies mos likely o con ain he a ge ed
genes. These a e lis ed in genomic coo dina es and ma ke (o p obe) indices.
(XLSX)
S12 Table. Lis o egions o homozygous loss ha occu in g ea e han wo pa ien s.
(DOCX)
S13 Table. Mu a ions in conse ed DNA sequences wi hin he minimal egions o soma ic
copy numbe al e a ion.
(XLSX)
S14 Table. S uc u al ea angemen s in egions o dele ion in ol ing genes ound o be in
o close o minimal egions o al e a ion.
(XLSX)
S15 Table. S uc u al ea angemen s in egions o dele ion in ol ing genes ound o be in
o close o GISTIC de ec ed egions.
(XLSX)
S16 Table. Pa hway en ichmen analysis o ETS posi i e and nega i e cance s using
mu a ed genes in signi ican egions o ampli ica ion and dele ion. The analysis was pe -
o med using he Reac ome plugin o analysis o canonical pa hways in Cy oscape. Only sig-
ni ican (FDR calcula ed using he Benjamini-Hochbe g p ocedu e p<0.05) en iched
pa hways wi h po en ial in ol emen in cance a e lis ed.
(XLSX)
S17 Table. Summa y able o he GISTIC de ec ed dele ions ha ollow he Knudson hi
model.
(DOCX)
S18 Table. Summa y o cases and copy numbe pla o ms.
(DOCX)
S1 Appendix. Example copy numbe plo s (BAF and logR) o ou umou samples (and
associa ed con ols) o each o he 24 no el MCRs ha we ha e iden i ied. The black lines
indica e he segmen de ec ed by ASCAT and he blue lines indica e he MCR egion.
(PDF)
S2 Appendix. An example s a is ical conside a ion o he Knudson 2-hi model.
(PDF)
S3 Appendix. Membe ship o he CRUK-ICGC p os a e g oup.
(PDF)
Acknowledgmen s
We hank he Human Resea ch Tissue Bank a Camb idge Adenb ooke’s Hospi al, ha is sup-
po ed by he NIHR Camb idge Biomedical Resea ch Cen e. We hank Da e Holland om
App aising he ele ance o copy numbe loss and gain in p os a e
PLOS Gene ics | h ps://doi.o g/10.1371/jou nal.pgen.1007001 Sep embe 25, 2017 22 / 28
he In as uc u e Managemen Team, Pe e Clapham om he In o ma ics Sys ems G oup a
he Wellcome T us Sange Ins i u e, and Bob Ge agh y om he Camb idge Ins i u e. The
au ho s would like o hank hose men wi h p os a e cance and he subjec s who ha e dona ed
hei ime and hei samples o his esea ch. We also would like o acknowledge he suppo o
Jo Bu ge, Ma ie Co co an, Anne Geo ge, and Sa a S ea n o sample cu a ion. PVL is a Win-
on G oup Leade in ecogni ion o he Win on Cha i able Founda ion’s suppo owa ds he
es ablishmen o The F ancis C ick Ins i u e.
Au ho Con ibu ions
Concep ualiza ion: Niedzica Camacho, Da id E. Neal, Rosalind Eeles, Colin S. Coope , Dan-
iel S. B ewe .
Da a cu a ion: Niedzica Camacho, Lucy Ma hews, Ba ba a K emeye , Jo ge Zamo a, Gunes
Gundem, Mohammed Gho i, Tapio Visako pi, Yong Jie Lu, Daniel S. B ewe .
Fo mal analysis: Niedzica Camacho, Ke s in Haase, Ba ba a K emeye , Daniel S. B ewe .
Funding acquisi ion: Ch is ophe S. Fos e , Ul an McDe mo , Da id E. Neal, Rosalind Eeles,
Colin S. Coope .
In es iga ion: Niedzica Camacho, Sand a Edwa ds, Jona han D. Kay, Lucy Ma hews, Je emy
Cla k, Nening Dennis, Sa ah Thomas, Jo ge Zamo a, Sue Me son, Hayley Lux on, S e e
Hawkins, Luke Ma sden, Adam Lambe , Ka alin Ka aszi, Gill Pel ende , Cha lie E. Massie,
William J. Howa , S e en Hazell, Naomi Li ni, Cy il Fishe , Ch is ophe Ogden, Pa deep
Kuma , Alan Thompson, Da id Nicol, E ik Maye , Tim Dudde idge, Yongwei Yu, Hon-
gwei Zhang, Nimish C. Shah, Vincen J. Gnanap agasam, F eddie Hamdy, Dan Be ney,
Cla e Ve ill, Anne Y. Wa en, And ew G. Lynch, Ch is ophe S. Fos e , Yong Jie Lu, G.
S e en Bo a, Hayley C. Whi ake , Ul an McDe mo , Rosalind Eeles, Colin S. Coope , Dan-
iel S. B ewe .
Me hodology: Niedzica Camacho, Pe e Van Loo, Jona han D. Kay, Lucy Ma hews, Je emy
Cla k, Daniel S. B ewe .
P ojec adminis a ion: Sand a Edwa ds, Sa ah Thomas, Adam P. Bu le , Gunes Gundem,
Mohammed Gho i, Cha lie E. Massie, Da id C. Wedge, And ew G. Lynch, Ch is ophe S.
Fos e , Da id E. Neal, Rosalind Eeles, Colin S. Coope , Daniel S. B ewe .
Resou ces: Nening Dennis, Sa ah Thomas, Sue Me son, Hayley Lux on, S e e Hawkins, Luke
Ma sden, Adam Lambe , Ka alin Ka aszi, Gill Pel ende , Zso ia Ko e-Ja ai, Kei an Raine,
Da id Jones, William J. Howa , S e en Hazell, Naomi Li ni, Cy il Fishe , Ch is ophe
Ogden, Pa deep Kuma , Alan Thompson, Da id Nicol, E ik Maye , Tim Dudde idge,
Yongwei Yu, Hongwei Zhang, Nimish C. Shah, Vincen J. Gnanap agasam, William Isaacs,
Tapio Visako pi, F eddie Hamdy, Dan Be ney, Cla e Ve ill, Anne Y. Wa en, Da id C.
Wedge, And ew G. Lynch, Ch is ophe S. Fos e , Yong Jie Lu, G. S e en Bo a, Hayley C.
Whi ake , Ul an McDe mo , Da id E. Neal, Rosalind Eeles, Colin S. Coope , Daniel S.
B ewe .
So wa e: Niedzica Camacho, Pe e Van Loo, Jo ge Zamo a, Adam P. Bu le , Mohammed
Gho i, Kei an Raine, Da id Jones, Daniel S. B ewe .
Supe ision: Pe e Van Loo, Je emy Cla k, Adam P. Bu le , Zso ia Ko e-Ja ai, Vincen J. Gna-
nap agasam, Da id C. Wedge, G. S e en Bo a, Hayley C. Whi ake , Ul an McDe mo ,
Da id E. Neal, Rosalind Eeles, Colin S. Coope , Daniel S. B ewe .
App aising he ele ance o copy numbe loss and gain in p os a e
PLOS Gene ics | h ps://doi.o g/10.1371/jou nal.pgen.1007001 Sep embe 25, 2017 23 / 28
Valida ion: Niedzica Camacho, Ke s in Haase, Daniel S. B ewe .
Visualiza ion: Niedzica Camacho, Daniel S. B ewe .
W i ing – o iginal d a : Niedzica Camacho, Pe e Van Loo, Colin S. Coope , Daniel S.
B ewe .
W i ing – e iew & edi ing: Niedzica Camacho, Sand a Edwa ds, Ke s in Haase, Je emy
Cla k, Cha lie E. Massie, Da id C. Wedge, And ew G. Lynch, Ch is ophe S. Fos e , Yong
Jie Lu, G. S e en Bo a, Da id E. Neal, Rosalind Eeles, Colin S. Coope , Daniel S. B ewe .
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