Pan-cancer analysis of the extent and consequences of intratumor heterogeneity

Noemi Andor, Trevor A. Graham, Marnix Jansen, Li C. Xia, C Athena Aktipis, Claudia Petritsch, Hanlee P. Ji, Carlo Maley

Research output: Contribution to journalArticle

285 Scopus citations

Abstract

Intratumor heterogeneity (ITH) drives neoplastic progression and therapeutic resistance. We used the bioinformatics tools 'expanding ploidy and allele frequency on nested subpopulations' (EXPANDS) and PyClone to detect clones that are present at a â ‰1 10% frequency in 1,165 exome sequences from tumors in The Cancer Genome Atlas. 86% of tumors across 12 cancer types had at least two clones. ITH in the morphology of nuclei was associated with genetic ITH (Spearman's correlation coefficient, ρ = 0.24-0.41; P < 0.001). Mutation of a driver gene that typically appears in smaller clones was a survival risk factor (hazard ratio (HR) = 2.15, 95% confidence interval (CI): 1.71-2.69). The risk of mortality also increased when >2 clones coexisted in the same tumor sample (HR = 1.49, 95% CI: 1.20-1.87). In two independent data sets, copy-number alterations affecting either <25% or >75% of a tumor's genome predicted reduced risk (HR = 0.15, 95% CI: 0.08-0.29). Mortality risk also declined when >4 clones coexisted in the sample, suggesting a trade-off between the costs and benefits of genomic instability. ITH and genomic instability thus have the potential to be useful measures that can universally be applied to all cancers.

Original languageEnglish (US)
Pages (from-to)105-113
Number of pages9
JournalNature Medicine
Volume22
Issue number1
DOIs
StatePublished - Jan 1 2016

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

Fingerprint Dive into the research topics of 'Pan-cancer analysis of the extent and consequences of intratumor heterogeneity'. Together they form a unique fingerprint.

  • Cite this

    Andor, N., Graham, T. A., Jansen, M., Xia, L. C., Aktipis, C. A., Petritsch, C., Ji, H. P., & Maley, C. (2016). Pan-cancer analysis of the extent and consequences of intratumor heterogeneity. Nature Medicine, 22(1), 105-113. https://doi.org/10.1038/nm.3984