Abstract There is an urgent need for more efficient and more targeted methods of prostate cancer treatment. We have previously shown PLA2G7 (also known as lipoprotein-associated phospholipase A2, Lp-PLA2) to be a possible biomarker and drug target especially in ERG positive prostate cancers by combining gene expression data from prostate cancer tissues in vivo and functional RNAi studies in vitro. To further study the potential of PLA2G7 in prostate cancer management immunohistochemical staining of 119 clinical prostate cancer samples and 112 adjacent normal prostate samples were performed. In addition, a global lipidomic, eicosanoid and gene expression analysis was utilized to study the effect of PLA2G7 silencing in ERG oncogene positive prostate cancer cells. The results emphasized high expression of PLA2G7 in 66 % of the cancer samples, whereas less than 4 % of the adjacent normal tissues showed positive staining. Furthermore, PLA2G7 expression significantly correlated with high Gleason score. PLA2G7 silencing in vitro induced a reduction in the amount of lysophosphatidyl choline and leukotriene E4, as well as in the expression of multiple genes and signaling pathways involved in cell adhesion and motility. In accordance, knock-down of PLA2G7 in 3D prostate cancer cell culture model lead to decreased invasion to extracellular matrix. Interestingly, PLA2G7 silencing also reduced the expression of ALDH1A1, a marker for malignant prostate stem cells and predictor of poor prostate cancer outcome. In conclusion, these novel findings suggest an oncogenic role for PLA2G7 in aggressive prostate cancers and support the rationale for PLA2G7 targeted therapy in these cancers. A novel PLA2G7 inhibitor is currently under clinical evaluation for cardiovascular diseases, presenting thus an interesting opportunity for drug repositioning to other indications, such as prostate cancer. In addition, lipid-lowering statins are known to lower PLA2G7 mass and activity, therefore PLA2G7 may also represent a target of lipid-lowering therapy in reducing the risk of aggressive prostate cancer. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 2597. doi:10.1158/1538-7445.AM2011-2597