Background

• Prostate cancer (PC) has a median onset age of 66, however, recent evidence suggests an increase in incidence of PC diagnosis in males <55 years of age.
• Family history and increased mutational burden has been associated with early onset PC (EOPC), nonetheless, comprehensive molecular and immune signatures that cluster in EOPC and average onset PC (AOPC) is poorly understood.
• Here, we characterized EOPC and AOPC, and their association with molecular and immune signature.

Conclusions

• Our data suggest that EOPC is enriched in fusion events including TMPRSS2, ETV1, ETV4 and BRAF. Distinct transcriptomic features seen in EOPC included neuroendocrine differentiation, MAPK activations, immunomodulatory gene expression, and increased infiltration of NK cells and dendritic cells, suggesting inherent molecular differences and differential tumor immune microenvironment in EOPC and AOPC