Biology subjects

Sahinalp, S. C.

Publications and source records attributed to Sahinalp, S. C..

At least 19 recordsLinked to original sources

bioRxiv2026

Qombucha: Reconstructing unobserved progenitor methylation profiles reveals distinct developmental programs in glioblastoma

Glioblastoma (GBM) is a highly aggressive brain cancer characterized by substantial intratumoral heterogeneity. Previous research demonstrates that GBM may have complex cell origins. To elucidate the interplay between brain development and GBM progression, we developed Qombucha (Quadratic prOgraMming Based tUmor deConvolution with cell HierArchy), a computational framework that uses DNA methylation data to infer tumor cell-type composition and profiles of unobserved progenitor cells. Unprecedentedly, Qombucha incorporates a developmental cell hierarchy that models mature brain cell types and their progenitors. Applied to a large TCGA GBM dataset spanning the RTK I, RTK II, and MES TYP subtypes, Qombucha identifies a distinct cell type composition profile for each subtype and recapitulates known biological patterns, including elevated microglia infiltration in MES TYP tumors. It also identifies subtype-specific developmental programs and shows that higher progenitor-cell abundance is associated with poorer survival. Qombucha-imputed cell fractions map methylation profiles of tumor samples to a compact, 11-dimensional latent space; in an independent NCI GBM cohort, this compact representation improves subtype clustering and enables accurate subtype classification, achieving performance comparable to state-of-the-art models based on full methylation profiles with much higher dimensionality. These results suggest that tumor cellular composition captures the core biological axes along which GBM subtypes diverge.

bioinformatics↗

bioRxiv2025

Long-read sequencing of single cell-derived melanoma subclones reveals divergent and parallel genomic and epigenomic evolutionary trajectories

Tumor evolution is driven by various mutational processes, ranging from single-nucleotide vari- ants (SNVs) to large structural variants (SVs) to dynamic shifts in DNA methylation. Current short-read sequencing methods struggle to accurately capture the full spectrum of these genomic and epigenomic alter- ations due to inherent technical limitations. To overcome that, here we introduce an approach for long-read sequencing of single-cell derived subclones, and use it to profile 23 subclones of a mouse melanoma cell line, characterized with distinct growth phenotypes and treatment responses. We develop a computational frame- work for harmonization and joint analysis of different variant types in the evolutionary context. Uniquely, our framework enables detection of recurrent amplifications of putative driver genes, generated by indepen- dent SVs across different lineages, suggesting parallel evolution. In addition, our approach revealed gradual and lineage-specific methylation changes associated with aggressive clonal phenotypes. We also show our set of phylogeny-constrained variant calls along with openly released sequencing data can be a valuable resource for the development of new computational methods.

genomics↗

bioRxiv2024

TX-Phase: Secure Phasing of Private Genomes in a Trusted Execution Environment

Genotype imputation servers enable researchers with limited resources to extract valuable insights from their data with enhanced accuracy and ease. However, the utility of these services is limited for those with sensitive study cohorts or those in restrictive regulatory environments due to data privacy concerns. Although privacy-preserving analysis tools have been developed to broaden access to these servers, none of the existing methods support haplotype phasing, a critical component of the imputation workflow. The complexity of phasing algorithms poses a significant challenge in maintaining practical performance under privacy constraints. Here, we introduce TX-Phase, a secure haplotype phasing method based on the framework of Trusted Execution Environments (TEEs). TX-Phase allows users private genomic data to be phased while ensuring data confidentiality and integrity of the computation. We introduce novel data-oblivious algorithmic techniques based on compressed reference panels and dynamic fixed-point arithmetic that comprehensively mitigate side-channel leakages in TEEs to provide robust protection of users genomic data throughout the analysis. Our experiments on a range of datasets from the UK Biobank and Haplotype Reference Consortium demonstrate the state-of-the-art phasing accuracy and practical runtimes of TX-Phase. Our work enables secure phasing of private genomes, opening access to large reference genomic datasets for a broader scientific community.

bioinformatics↗

bioRxiv2024

Biologically-informed Killer cell immunoglobulin-like receptor (KIR) gene annotation tool

Natural killer (NK) cells are essential components of the innate immune system, with their activity significantly regulated by Killer cell Immunoglobulin-like Receptors (KIRs). The diversity and structural complexity of KIR genes present significant challenges for accurate genotyping, essential for understanding NK cell functions and their implications in health and disease. Traditional genotyping methods struggle with the variable nature of KIR genes, leading to inaccuracies that can impede immunogenetic research. These challenges extend to high-quality phased assemblies, which have been recently popularized by the Human Pangenome Consortium. This paper introduces BAKIR (Biologically-informed Annotator for KIR locus), a tailored computational tool designed to overcome the challenges of KIR genotyping and annotation on high-quality, phased genome assemblies. BAKIR aims to enhance the accuracy of KIR gene annotations by structuring its annotation pipeline around identifying key functional mutations, thereby improving the identification and subsequent relevance of gene and allele calls. It uses a multi-stage mapping, alignment, and variant calling process to ensure high-precision gene and allele identification, while also maintaining high recall for sequences that are significantly mutated or truncated relative to the known allele database. BAKIR has been evaluated on a subset of the HPRC assemblies, where BAKIR was able to improve many of the associated annotations and call novel variants. BAKIR is freely available on GitHub, offering ease of access and use through multiple installation methods, including pip, conda, and singularity container, and is equipped with a user-friendly command-line interface, thereby promoting its adoption in the scientific community.

genomics↗

bioRxiv2024

Fair molecular feature selection unveils universally tumor lineage-informative methylation sites in colorectal cancer

In the era of precision medicine, performing comparative analysis over diverse patient populations is a fundamental step towards tailoring healthcare interventions. However, the critical aspect of equitably selecting molecular features across multiple patients is often overlooked. To address this challenge, we introduce FALAFL (FAir muLti-sAmple Feature seLection), an algorithmic approach based on combinatorial optimization. FALAFL is designed to bridge the gap between molecular feature selection and algorithmic fairness, ensuring a fair selection of molecular features from all patient samples in a cohort. We have applied FALAFL to the problem of selecting lineage-informative CpG sites within a cohort of colorectal cancer patients subjected to low read coverage single-cell methylation sequencing. Our results demonstrate that FALAFL can rapidly and robustly determine the optimal set of CpG sites, which are each well covered by cells across the vast majority of the patients, while ensuring that in each patient a high proportion of these sites have good read coverage. An analysis of the FALAFL-selected sites reveals that their tumor lineage-informativeness exhibits a strong correlation across a spectrum of diverse patient profiles. Furthermore, these universally lineage-informative sites are highly enriched in the inter CpG island regions. FALAFL integrates equity considerations into the molecular feature selection from single-cell sequencing data obtained from a patient cohort. We hope that it will help propel equitable healthcare data science practices and contribute to the advancement of our understanding of complex diseases.

bioinformatics↗

bioRxiv2021

Profiles of expressed mutations in single cells reveal patterns of tumor evolution and therapeutic impact of intratumor heterogeneity

Advances in single-cell RNA sequencing (scRNAseq) technologies uncovered an unexpected complexity in tumors, underlining the relevance of intratumor heterogeneity to cancer progression and therapeutic resistance. Heterogeneity in the mutational composition of cancer cells is a result of distinct (sub)clonal expansions, each with a distinct metastatic potential and resistance to specific treatments. Unfortunately, due to their low read coverage per cell, scRNAseq datasets are too sparse and noisy to be used for detecting expressed mutations in single cells. Additionally, the large number of cells and mutations present in typical scRNAseq datasets are too large for available computational tools to, e.g., infer distinct subclones, lineages or trajectories in a tumor. Finally, there are no principled methods to assess distinct subclones inferred through single-cell sequencing data and the genomic alterations that seed and potentially cause them. Here we present Trisicell, a computational toolkit for scalable mutational intratumor heterogeneity inference and assessment from scRNAseq as well as single-cell genome or exome sequencing data. Trisicell allows reliable identification of distinct clonal lineages of a tumor, offering the ability to focus on the most important subclones and the genomic alterations that are associated with tumor proliferation. We comprehensively assessed Trisicell on a melanoma model by comparing distinct lineages and subclones it identifies on scRNAseq data, to those inferred using matching bulk whole exome (bWES) and transcriptome (bWTS) sequencing data from clonal sublines derived from single cells. Our results demonstrate that distinct lineages and subclones of a tumor can be reliably inferred and evaluated based on mutation calls from scRNAseq data through the use of Trisicell. Additionally, they reveal a strong correlation between aggressiveness and mutational composition, both across the inferred subclones, and among human melanomas. We also applied Trisicell to infer and evaluate distinct subclonal expansion patterns of the same mouse melanoma model after treatment with immune checkpoint blockade (ICB). After integratively analyzing our cell-specific mutation calls with their expression profiles, we observed that each subclone with a distinct set of novel somatic mutations is strongly associated with a specific developmental status. Moreover, each subclone had developed a unique ICB-resistance mechanism. These results demonstrate that Trisicell can robustly utilize scRNAseq data to delineate intratumor heterogeneity and help understand biological mechanisms underlying tumor progression and resistance to therapy.

bioinformatics↗

bioRxiv2021

Epigenomic tumor evolution modeling with single-cell methylation data profiling

Recent studies exploring the impact of methylation in tumor evolution suggest that while the methylation status of many of the CpG sites are preserved across distinct lineages, others are altered as the cancer progresses. Since changes in methylation status of a CpG site may be retained in mitosis, they could be used to infer the progression history of a tumor via single-cell lineage tree reconstruction. In this work, we introduce the first principled distance-based computational method, Sgootr, for inferring a tumors single-cell methylation lineage tree and jointly identifying lineage-informative CpG sites which harbor changes in methylation status that are retained along the lineage. We apply Sgootr on the single-cell bisulfite-treated whole genome sequencing data of multiregionally-sampled tumor cells from 9 metastatic colorectal cancer patients made available by Bian et al., as well as multiregionally-sampled single-cell reduced-representation bisulfite sequencing data from a glioblastoma patient made available by Chaligne et al.. We demonstrate that the tumor lineages constructed reveal a simple model underlying colorectal tumor progression and metastatic seeding. A comparison of Sgootr against alternative approaches shows that Sgootr can construct lineage trees with fewer migration events and more in concordance with the sequential-progression model of tumor evolution, in time a fraction of that used in prior studies. Interestingly, lineage-informative CpG sites identified by Sgootr are in inter-CpG island (CGI) regions, as opposed to CGIs, which have been the main regions of interest in genomic methylation-related analyses. Sgootr is implemented as a Snakemake workflow, available at https://github.com/algo-cancer/Sgootr. O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=63 SRC="FIGDIR/small/436475v2_ufig1.gif" ALT="Figure 1"> View larger version (27K): org.highwire.dtl.DTLVardef@1d3920aorg.highwire.dtl.DTLVardef@11905d4org.highwire.dtl.DTLVardef@1cda90aorg.highwire.dtl.DTLVardef@114ea18_HPS_FORMAT_FIGEXP M_FIG C_FIG

cancer biology↗

bioRxiv2021

Privacy-Preserving Genotype Imputation in a Trusted Execution Environment

Genotype imputation is an essential tool in genetics research, whereby missing genotypes are inferred based on a panel of reference genomes to enhance the power of downstream analyses. Recently, public imputation servers have been developed to allow researchers to leverage increasingly large-scale and diverse genetic data repositories for imputation. However, privacy concerns associated with uploading ones genetic data to a third-party server greatly limit the utility of these services. In this paper, we introduce a practical, secure hardware-based solution for a privacy-preserving imputation service, which keeps the input genomes private from the service provider by processing the data only within a Trusted Execution Environment (TEE) offered by the Intel SGX technology. Our solution features SMac, an efficient, side-channel-resilient imputation algorithm designed for Intel SGX, which employs the hidden Markov model (HMM)-based imputation strategy also utilized by a state-of-the-art imputation software Minimac. SMac achieves imputation accuracies virtually identical to those of Minimac and provides protection against known attacks on SGX while maintaining scalability to large datasets. We additionally show the necessity of our strategies for mitigating side-channel risks by identifying vulnerabilities in existing imputation software and controlling their information exposure. Overall, our work provides a guideline for practical and secure implementation of genetic analysis tools in SGX, representing a step toward privacy-preserving analysis services that can facilitate data sharing and accelerate genetics research.{dagger} AvailabilityOur software is available at https://github.com/ndokmai/sgx-genotype-imputation.

bioinformatics↗

bioRxiv2020

Studying the history of tumor evolution from single-cell sequencing data by exploring the space of binary matrices

Single-cell sequencing data has great potential in reconstructing the evolutionary history of tumors. Rapid advances in single-cell sequencing technology in the past decade were followed by the design of various computational methods for inferring trees of tumor evolution. Some of the earliest of these methods were based on the direct search in the space of trees. However, it can be shown that instead of this tree search strategy we can perform a search in the space of binary matrices and obtain the most likely tree directly from the most likely among the candidate binary matrices. The search in the space of binary matrices can be expressed as an instance of integer linear or constraint satisfaction programming and solved by some of the available solvers, which typically provide a guarantee of optimality of the reported solution. In this review, we first describe one convenient tree representation of tumor evolutionary history and present tree scoring model that is most commonly used in the available methods. We then provide proof showing that the most likely tree of tumor evolution can be obtained directly from the most likely matrix from the space of candidate binary matrices. Next, we provide integer linear programming formulation to search for such matrix and summarize the existing methods based on this formulation or its extensions. Lastly, we present one use-case which illustrates how binary matrices can be used as a basis for developing a fast deep learning method for inferring some topological properties of the most likely tree of tumor evolution.

bioinformatics↗

bioRxiv2020

Tumor Phylogeny Topology Inference via Deep Learning

Principled computational approaches for tumor phylogeny reconstruction via single-cell sequencing typically aim to build the most likely perfect phylogeny tree from the noisy genotype matrix - which represents genotype calls of single-cells. This problem is NP-hard, and as a result, existing approaches aim to solve relatively small instances of it through combinatorial optimization techniques or Bayesian inference. As expected, even when the goal is to infer basic topological features of the tumor phylogeny - rather than reconstructing the topology entirely, these approaches could be prohibitively slow. In this paper, we introduce fast deep-learning solutions to the problems of inferring whether the most likely tree has a linear (chain) or branching topology and whether a perfect phylogeny is feasible from a given genotype matrix. We also present a reinforcement learning approach for reconstructing the most likely tumor phylogeny. This preliminary work demonstrates that data-driven approaches can reconstruct key features of tumor evolution.

bioinformatics↗

bioRxiv2020

PhISCS-BnB: A Fast Branch and Bound Algorithm for the Perfect Tumor Phylogeny Reconstruction Problem

MotivationRecent advances in single cell sequencing (SCS) offer an unprecedented insight into tumor emergence and evolution. Principled approaches to tumor phylogeny reconstruction via SCS data are typically based on general computational methods for solving an integer linear program (ILP), or a constraint satisfaction program (CSP), which, although guaranteeing convergence to the most likely solution, are very slow. Others based on Monte Carlo Markov Chain (MCMC) or alternative heuristics not only offer no such guarantee, but also are not faster in practice. As a result, novel methods that can scale up to handle the size and noise characteristics of emerging SCS data are highly desirable to fully utilize this technology. ResultsWe introduce PhISCS-BnB, a Branch and Bound algorithm to compute the most likely perfect phylogeny (PP) on an input genotype matrix extracted from a SCS data set. PhISCS-BnB not only offers an optimality guarantee, but is also 10 to 100 times faster than the best available methods on simulated tumor SCS data. We also applied PhISCS-BnB on a large melanoma data set derived from the sub-lineages of a cell line involving 24 clones with 3574 mutations, which returned the optimal tumor phylogeny in less than 2 hours. The resulting phylogeny also agrees with bulk exome sequencing data obtained from in vivo tumors growing out from the same cell line. Availabilityhttps://github.com/algo-cancer/PhISCS-BnB

bioinformatics↗

bioRxiv2018

Pathway and network analysis of more than 2,500 whole cancer genomes

The catalog of cancer driver mutations in protein-coding genes has greatly expanded in the past decade. However, non-coding cancer driver mutations are less well-characterized and only a handful of recurrent non-coding mutations, most notably TERT promoter mutations, have been reported. Motivated by the success of pathway and network analyses in prioritizing rare mutations in protein-coding genes, we performed multi-faceted pathway and network analyses of non-coding mutations across 2,583 whole cancer genomes from 27 tumor types compiled by the ICGC/TCGA PCAWG project. While few non-coding genomic elements were recurrently mutated in this cohort, we identified 93 genes harboring non-coding mutations that cluster into several modules of interacting proteins. Among these are promoter mutations associated with reduced mRNA expression in TP53, TLE4, and TCF4. We found that biological processes had variable proportions of coding and non-coding mutations, with chromatin remodeling and proliferation pathways altered primarily by coding mutations, while developmental pathways, including Wnt and Notch, altered by both coding and non-coding mutations. RNA splicing was primarily targeted by non-coding mutations in this cohort, with samples containing non-coding mutations exhibiting similar gene expression signatures as coding mutations in well-known RNA splicing factors. These analyses contribute a new repertoire of possible cancer genes and mechanisms that are altered by non-coding mutations and offer insights into additional cancer vulnerabilities that can be investigated for potential therapeutic treatments.

cancer biology↗

bioRxiv2018

PhISCS - A Combinatorial Approach for Sub-perfect Tumor Phylogeny Reconstruction via Integrative use of Single Cell and Bulk Sequencing Data

Recent technological advances in single cell sequencing (SCS) provide high resolution data for studying intra-tumor heterogeneity and tumor evolution. Available computational methods for tumor phylogeny inference via SCS typically aim to identify the most likely perfect phylogeny tree satisfying infinite sites assumption (ISA). However limitations of SCS technologies such as frequent allele dropout or highly variable sequence coverage, commonly result in mutational call errors and prohibit a perfect phylogeny. In addition, ISA violations are commonly observed in tumor phylogenies due to the loss of heterozygosity, deletions and convergent evolution. In order to address such limitations, we, for the first time, introduce a new combinatorial formulation that integrates single cell sequencing data with matching bulk sequencing data, with the objective of minimizing a linear combination of (i) potential false negatives (due to e.g. allele dropout or variance in sequence coverage) and (ii) potential false positives (due to e.g. read errors) among mutation calls, as well as (iii) the number of mutations that violate ISA - to define the optimal sub-perfect phylogeny. Our formulation ensures that several lineage constraints imposed by the use of variant allele frequencies (VAFs, derived from bulk sequence data) are satisfied. We express our formulation both in the form of an integer linear program (ILP) and - for the first time in the context of tumor phylogeny reconstruction - a boolean constraint satisfaction problem (CSP) and solve them by leveraging state-of-the-art ILP/CSP solvers. The resulting method, which we name PhISCS, is the first to integrate SCS and bulk sequencing data under the finite sites model. Using several simulated and real SCS data sets, we demonstrate that PhISCS is not only more general but also more accurate than the alternative tumor phylogeny inference tools. PhISCS is very fast especially when its CSP based variant is used returns the optimal solution, except in rare instances for which it provides an optimality gap. PhISCS is available at https://github.com/haghshenas/PhISCS.

bioinformatics↗

bioRxiv2018

Combinatorial Detection of Conserved Alteration Patterns for Identifying Cancer Subnetworks

BackgroundAdvances in large scale tumor sequencing have lead to an understanding that there are combinations of genomic and transcriptomic alterations speciflc to tumor types, shared across many patients. Unfortunately, computational identiflcation of functionally meaningful shared alteration patterns, impacting gene/protein interaction subnetworks, has proven to be challenging. FindingsWe introduce a novel combinatorial method, cd-CAP, for simultaneous detection of connected subnetworks of an interaction network where genes exhibit conserved alteration patterns across tumor samples. Our method differentiates distinct alteration types associated with each gene (rather than relying on binary information of a gene being altered or not), and simultaneously detects multiple alteration proflle conserved subnetworks. ConclusionsIn a number of The Cancer Genome Atlas (TCGA) data sets, cd-CAP identifled large biologically signiflcant subnetworks with conserved alteration patterns, shared across many tumor samples.

systems biology↗

bioRxiv2018

Portraits of genetic intra-tumour heterogeneity and subclonal selection across cancer types

Intra-tumor heterogeneity (ITH) is a mechanism of therapeutic resistance and therefore an important clinical challenge. However, the extent, origin and drivers of ITH across cancer types are poorly understood. To address this question, we extensively characterize ITH across whole-genome sequences of 2,658 cancer samples, spanning 38 cancer types. Nearly all informative samples (95.1%) contain evidence of distinct subclonal expansions, with frequent branching relationships between subclones. We observe positive selection of subclonal driver mutations across most cancer types, and identify cancer type specific subclonal patterns of driver gene mutations, fusions, structural variants and copy-number alterations, as well as dynamic changes in mutational processes between subclonal expansions. Our results underline the importance of ITH and its drivers in tumor evolution, and provide an unprecedented pan-cancer resource of comprehensively annotated subclonal events from whole-genome sequencing data.

cancer biology↗

bioRxiv2018

BAP1 Loss Predicts Therapeutic Vulnerability in Malignant Peritoneal Mesothelioma

BackgroundMalignant Peritoneal Mesothelioma (PeM) is a rare but frequently fatal cancer that originates from the peritoneal lining of the abdomen. Standard treatment of PeM is limited to cytoreductive surgery and/or chemotherapy, and no effective targeted therapies for PeM yet exist. In the search for novel therapeutic target candidates in PeM, we performed a comprehensive integrative multi-omics analysis of 19 treatment-naive PeM tumors.\n\nResultsThe analysis identified PeM tumors with BAP1 loss to form a distinct molecular subtype characterized by distinct expression patterns of genes involved in chromatin remodeling, DNA repair pathway, and immune checkpoint receptor activation. This PeM subtype could potentially benefit from immune checkpoint, PARP, or HDAC inhibition therapies.\n\nConclusionsOur findings uncover BAP1 as a trackable prognostic and predictive biomarker, and refine PeM disease classification. This integrated molecular characterization provides a comprehensive foundation for developing PeM precision medicine.

cancer biology↗

bioRxiv2017

Computational proteogenomic identification and functional interpretation of translated fusions and micro structural variations in cancer

MotivationRapid advancement in high throughput genome and transcriptome sequencing (HTS) and mass spectrometry (MS) technologies has enabled the acquisition of the genomic, transcriptomic and proteomic data from the same tissue sample. In this paper we introduce a novel computational framework which can integratively analyze all three types of omics data to obtain a complete molecular profile of a tissue sample, in normal and disease conditions. Our framework includes MiStrVar, an algorithmic method we developed to identify micro structural variants (microSVs) on genomic HTS data. Coupled with deFuse, a popular gene fusion detection method we developed earlier, MiStrVar can provide an accurate profile of structurally aberrant transcripts in cancer samples. Given the breakpoints obtained by MiStrVar and deFuse, our framework can then identify all relevant peptides that span the breakpoint junctions and match them with unique proteomic signatures in the respective proteomics data sets. Our framework's ability to observe structural aberrations at three levels of omics data provides means of validating their presence.\n\nResultsWe have applied our framework to all The Cancer Genome Atlas (TCGA) breast cancer Whole Genome Sequencing (WGS) and/or RNA-Seq data sets, spanning all four major subtypes, for which proteomics data from Clinical Proteomic Tumor Analysis Consortium (CPTAC) have been released. A recent study on this dataset focusing on SNVs has reported many that lead to novel peptides [1]. Complementing and significantly broadening this study, we detected 244 novel peptides from 432 candidate genomic or transcriptomic sequence aberrations. Many of the fusions and microSVs we discovered have not been reported in the literature. Interestingly, the vast majority of these translated aberrations (in particular, fusions) were private, demonstrating the extensive inter-genomic heterogeneity present in breast cancer. Many of these aberrations also have matching out-of-frame downstream peptides, potentially indicating novel protein sequence and structure. Moreover, the most significantly enriched genes involved in translated fusions are cancer-related. Furthermore a number of the somatic, translated microSVs are observed in tumor suppressor genes.\n\nContactcenksahi@indiana.edu

bioinformatics↗

bioRxiv2017

The evolutionary history of 2,658 cancers

Cancer develops through a process of somatic evolution. Here, we use whole-genome sequencing of 2,778 tumour samples from 2,658 donors to reconstruct the life history, evolution of mutational processes, and driver mutation sequences of 39 cancer types. The early phases of oncogenesis are driven by point mutations in a small set of driver genes, often including biallelic inactivation of tumour suppressors. Early oncogenesis is also characterised by specific copy number gains, such as trisomy 7 in glioblastoma or isochromosome 17q in medulloblastoma. By contrast, increased genomic instability, a nearly four-fold diversification of driver genes, and an acceleration of point mutation processes are features of later stages. Copy-number alterations often occur in mitotic crises leading to simultaneous gains of multiple chromosomal segments. Timing analysis suggests that driver mutations often precede diagnosis by many years, and in some cases decades, providing a window of opportunity for early cancer detection.

cancer biology↗