5133 Background: HDM2 overexpression occurs in a number of tumor types by different mechanisms. The G allele of the HDM2 promoter polymorphism, SNP309 (rs2279744), enhances transcriptional activation, which leads to greater HDM2 expression and accelerated tumor formation at a younger age for patients with Li Fraumeni syndrome and colon cancers. Here we evaluate the HDM2 overexpression in prostate tumors from AA and CA (pts) and examine the association between the G allele with HDM2 protein expression levels, early onset of prostate cancer, and worse clinical outcome. Methods: We studied 51 AA and 50 CA pts prospectively enrolled at the VAMC/New York University. Protein expression of HDM2 in prostate tumor was assessed using immunohistochemistry on tissue microarray. Germline DNA was isolated from normal prostate tissue; a 352bp HDM2 fragment containing SNP309 was amplified; the PCR products were digested with MspA1I restriction enzyme and run on agarose gels. The results were confirmed by DNA sequencing. We calculated HDM2 SNP309 genotype and allele frequencies and examined the association between HDM2 SNP309 genotype, tumor HDM2 protein and clinicopathological features. Results: HDM2 overexpression, defined as HDM2 expression in >10% of tumor cells in 3 cores, was significantly greater in CA pts (78%) vs. AA pts (55%, p=0.0007). The SNP309 allele frequency was not significantly different between AA and CA (81% T, 19% G among the AA pts vs. 72% T, 28% G among CA pts, P=0.41). There was a trend of HDM2 overexpression in AA pt with TG and/or GG compared to TT genotype (63% vs. 37%, respectively, p=0.09) that was not observed in CA pts. No significant associations were observed between a specific genotype and age at diagnosis, tumor stage, Gleason grade, PSA recurrence or death. Conclusions: HDM2 overexpression is significantly more common among CA pts. Although the frequency of the SNP309 G allele is higher in CA pts, in these same pts, HDM2 overexpression does not correlate with presence of the GT or GG genotype. Our data suggest that different mechanisms of HDM2 overexpression might exist in prostate cancer and may operate in pts of different races. No significant financial relationships to disclose.
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