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

Brown, David and Smeets, Dominiek and Székely, Borbála and Larsimont, Dennis and Szász, Attila Marcell and Adnet, PY and Rothe, F and Rougas, G and Nagy, Zsófia and Farago, Zsofia and Tőkés, Anna-Mária and Dank, Magdolna and Szentmártoni, Gyöngyvér and Udvarhelyi, Nóra and Zoppoli, G and Pusztai, Lajos and Piccart, Martine and Kulka, Janina and Lambrechts, Dieter and Sotiriou, Chrtistos and Desmedt, Christine (2017) Phylogenetic analysis of metastatic progression in breast cancer using somatic mutations and copy number aberrations. NATURE COMMUNICATIONS. ISSN 2041-1723

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Abstract

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.

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