Integrative Whole-Genome and Epigenome Profiling of cfDNA in Familial Prostate Cancer: Insights from a Pilot Study
Authors:
- Anna TrudaATAnna Truda
- Angela CordellaACAngela Cordella
- Ilenia De LeoILIlenia De Leo
- Armando Di PaloAPArmando Di Palo
- Roberta IorioRIRoberta Iorio
- Simona MarinoSMSimona Marino
- Roberto La RoccaRRRoberto La Rocca
- Claudia Collà RuvoloCRClaudia Collà Ruvolo
- Nicoletta PotenzaNicoletta Potenza
- Maria RavoMRMaria Ravo
- Giovanna MarcheseGMGiovanna Marchese
Open Access
- 3 April 2026
- journal article
- research article
- Published by MDPI AG in Biomedicines
- Vol. 14 (4) , 818
Abstract
Background: Familial prostate cancer (PCa) accounts for nearly 20% of all PCa cases and is associated with increased genetic susceptibility and earlier disease onset. However, early detection and risk stratification in genetically predisposed individuals remain challenging. Circulating cell-free DNA (cfDNA) provides a minimally invasive source of tumor-derived genomic and epigenomic information. Integrating multi-omic cfDNA analyses may enhance the discovery of biomarkers relevant to familial PCa biology. Methods: We conducted a pilot feasibility study employing whole-genome, strand-specific sequencing of cfDNA from eight patients with familial PCa. A unified analytical pipeline was used to jointly profile genomic alterations and epigenomic features. Variant calling, methylation mapping, and allele-specific methylation (ASM) analysis were performed to identify somatic mutations, characterize epigenetic dysregulation, and explore potential interactions between genetic and epigenetic mechanisms. Results: Sequencing revealed 18,878 genetic variants, including 2276 potentially pathogenic alterations. We identified 26 recurrent high-impact mutations, such as stop-gain and start-loss variants, in genes including MUC4, MCM9, and SKA3. Epigenomic profiling demonstrated widespread gene-specific hypermethylation, consistent with transcriptional repression in these loci. ASM events were detected in TTC22, TEX51, WDR89, LAIR2, and SKA3, suggesting coordinated interactions between somatic variation and epigenetic regulation in familial PCa. Conclusions: This proof-of-concept study highlights the feasibility and potential of integrating whole-genome and epigenome profiling of cfDNA to decode the molecular architecture of familial prostate cancer. By jointly capturing genomic alterations and epigenetic signatures, including allele-specific methylation, this multi-omic liquid biopsy approach supports a high-resolution exploration of biologically relevant molecular features. Moreover, this integrated profiling strategy provides a minimally invasive and clinically scalable tool that may substantially improve risk assessment. These findings offer a promising foundation for future validation studies in larger cohorts, with the aim of advancing multi-omic cfDNA analysis as a next-generation technology in the field of precision oncologic epigenetics.Keywords
Funding Information
- Ministry of Enterprises (130—CUP B19J23000570005)
This publication has 78 references indexed in Scilit:
- Prostate CancerJAMA, 2025
- Prostate Cancer: A Review of Genetics, Current Biomarkers and Personalised TreatmentsCancer Reports, 2024
- Cell-free DNA in the management of prostate cancer: Current status and future prospectiveAsian Journal of Urology, 2022
- Germline genetics of prostate cancerThe Prostate, 2022
- Variant interpretation using population databases: Lessons from gnomADHuman Mutation, 2021
- Candidate genes for hereditary colorectal cancer: Mutational screening and systematic reviewHuman Mutation, 2020
- MCM9 Mutations Are Associated with Ovarian Failure, Short Stature, and Chromosomal InstabilityThe American Journal of Human Genetics, 2014
- From FastQ Data to High‐Confidence Variant Calls: The Genome Analysis Toolkit Best Practices PipelineCurrent Protocols in Bioinformatics, 2013
- Vimentin DNA methylation predicts survival in breast cancerBreast Cancer Research and Treatment, 2012
- Aberrant expression of transmembrane mucins, MUC1 and MUC4, in human prostate carcinomasThe Prostate, 2005