Phylogenetic analysis of metastatic progression in breast cancer using somatic mutations and copy number aberrations

• Published in: Nature communications Vol. 8; no. 1; pp. 14944 - 13
• Main Authors: Brown, David, Smeets, Dominiek, Székely, Borbála, Larsimont, Denis, Szász, A. Marcell, Adnet, Pierre-Yves, Rothé, Françoise, Rouas, Ghizlane, Nagy, Zsófia I., Faragó, Zsófia, Tőkés, Anna-Mária, Dank, Magdolna, Szentmártoni, Gyöngyvér, Udvarhelyi, Nóra, Zoppoli, Gabriele, Pusztai, Lajos, Piccart, Martine, Kulka, Janina, Lambrechts, Diether, Sotiriou, Christos, Desmedt, Christine
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 21.04.2017; Nature Publishing Group; Nature Portfolio
• Subjects: 45; 45/23; 692/4028/67/1347; 692/4028/67/69; Adult; Aged; Autopsies; Autopsy; Breast cancer; Breast Neoplasms - classification; Breast Neoplasms - genetics; Breast Neoplasms - pathology; Cancer therapies; Clone Cells - metabolism; Clone Cells - pathology; Disease Progression; DNA Copy Number Variations; Exome Sequencing - methods; Female; Genetic Heterogeneity; Genomes; Heterogeneity; Humanities and Social Sciences; Humans; Lesions; Metastasis; Middle Aged; multidisciplinary; Mutation; Neoplasm Metastasis; Oncology; Pathology; Patients; Phylogenetics; Phylogeny; Science; Science (multidisciplinary); Surgery; Tumors; Hungary; Belgium
• ISSN: 2041-1723; 2041-1723
• DOI: 10.1038/ncomms14944

Several studies using genome-wide molecular techniques have reported various degrees of genetic heterogeneity between primary tumours and their distant metastases. However, it has been difficult to discern patterns of dissemination owing to the limited number of patients and available metastases. Here, we use phylogenetic techniques on data generated using whole-exome sequencing and copy number profiling of primary and multiple-matched metastatic tumours from ten autopsied patients to infer the evolutionary history of breast cancer progression. We observed two modes of disease progression. In some patients, all distant metastases cluster on a branch separate from their primary lesion. Clonal frequency analyses of somatic mutations show that the metastases have a monoclonal origin and descend from a common ‘metastatic precursor’. Alternatively, multiple metastatic lesions are seeded from different clones present within the primary tumour. We further show that a metastasis can be horizontally cross-seeded. These findings provide insights into breast cancer dissemination. Tumour heterogeneity is well-known; however, studies analysing the progression from primary to metastatic disease are still limited. Here, the authors used phylogenetic analyses and found that for some patients there are multiple seeding events from the primary tumour accompanied by cross-seeding between metastases.