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Higher LST in CTC were independent of CTC enumerated, clinically more indicative of aggressive behavior than co-occurring TSG losses, and molecularly associated to gains in chromosomal regions including PTK2, Myc and NCOA2, increased androgen receptor (AR) expression, and BRCA2 loss. In 57 patients with matched cell-free tumor DNA (ctDNA) data, CTC were more frequently detectable and evaluable for CNA analysis (in 73.7% vs 42.1%, respectively). CONCLUSIONS Our findings suggest that genomic instability in CTC is a hallmark of advanced pr