relation: http://publicatio.bibl.u-szeged.hu/35541/ title: Prospective validation of ORACLE, a clonal expression biomarker associated with survival of patients with lung adenocarcinoma creator: Biswas Dhruva creator: Liu Yun-Hsin creator: Herrero Javier creator: Snell Daniel M. creator: O’Neill Olga creator: Leonce Daniel creator: Mattsson Johanna creator: Lindberg Amanda creator: Micke Patrick creator: Moldvay Judit creator: Megyesfalvi Zsolt creator: Döme Balazs creator: Fillinger János creator: Nicod Jerome creator: Downward Julian creator: Kollaboráiós szervezet: TRACERx Consortium creator: et al. subject: 03.02. Klinikai orvostan description: Human tumors are diverse in their natural history and response to treatment, which in part results from genetic and transcriptomic heterogeneity. In clinical practice, single-site needle biopsies are used to sample this diversity, but cancer biomarkers may be confounded by spatiogenomic heterogeneity within individual tumors. Here we investigate clonally expressed genes as a solution to the sampling bias problem by analyzing multiregion whole-exome and RNA sequencing data for 450 tumor regions from 184 patients with lung adenocarcinoma in the TRACERx study. We prospectively validate the survival association of a clonal expression biomarker, Outcome Risk Associated Clonal Lung Expression (ORACLE), in combination with clinicopathological risk factors, and in stage I disease. We expand our mechanistic understanding, discovering that clonal transcriptional signals are detectable before tissue invasion, act as a molecular fingerprint for lethal metastatic clones and predict chemotherapy sensitivity. Lastly, we find that ORACLE summarizes the prognostic information encoded by genetic evolutionary measures, including chromosomal instability, as a concise 23-transcript assay. date: 2025 type: Folyóiratcikk type: PeerReviewed format: text identifier: http://publicatio.bibl.u-szeged.hu/35541/7/35681466.pdf format: text identifier: http://publicatio.bibl.u-szeged.hu/35541/1/Nature.pdf identifier: Biswas Dhruva; Liu Yun-Hsin; Herrero Javier; Snell Daniel M.; O’Neill Olga; Leonce Daniel; Mattsson Johanna; Lindberg Amanda; Micke Patrick; Moldvay Judit; Megyesfalvi Zsolt; Döme Balazs; Fillinger János; Nicod Jerome; Downward Julian; Kollaboráiós szervezet: TRACERx Consortium; et al.: Prospective validation of ORACLE, a clonal expression biomarker associated with survival of patients with lung adenocarcinoma. NATURE CANCER, 6 (1). pp. 86-101. ISSN 2662-1347 (2025) identifier: doi:10.1038/s43018-024-00883-1 relation: https://doi.org/10.1038/s43018-024-00883-1 relation: 35681466 language: eng