title: Tracking genomic cancer evolution for precision medicine: the lung TRACERx study.
abstract: The importance of intratumour genetic and functional heterogeneity is increasingly recognised as a driver of cancer progression and survival outcome. Understanding how tumour clonal heterogeneity impacts upon therapeutic outcome, however, is still an area of unmet clinical and scientific need. TRACERx (TRAcking non-small cell lung Cancer Evolution through therapy [Rx]), a prospective study of patients with primary non-small cell lung cancer (NSCLC), aims to define the evolutionary trajectories of lung cancer in both space and time through multiregion and longitudinal tumour sampling and genetic analysis. By following cancers from diagnosis to relapse, tracking the evolutionary trajectories of tumours in relation to therapeutic interventions, and determining the impact of clonal heterogeneity on clinical outcomes, TRACERx may help to identify novel therapeutic targets for NSCLC and may also serve as a model applicable to other cancer types.
authors.affiliation: Translational Cancer Therapeutics Laboratory, University College London Cancer Institute, London, United Kingdom; Department of Medical Oncology, University College London Hospitals, London, United Kingdom.
authors.forename: Mariam
authors.initials: M
authors.lastname: Jamal-Hanjani
authors.affiliation: Cancer Research UK & UCL Cancer Trials Centre, London, United Kingdom.
authors.forename: Alan
authors.initials: A
authors.lastname: Hackshaw
authors.affiliation: Cancer Research UK & UCL Cancer Trials Centre, London, United Kingdom.
authors.forename: Yenting
authors.initials: Y
authors.lastname: Ngai
authors.affiliation: Cancer Studies and Molecular Medicine, University of Leicester, Leicester, United Kingdom.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Shaw
authors.affiliation: Cancer Research UK Manchester Institute, Manchester, United Kingdom.
authors.forename: Caroline
authors.initials: C
authors.lastname: Dive
authors.affiliation: Immune Regulation and Tumour Immunotherapy Laboratory, University College London Cancer Institute, London, United Kingdom.
authors.forename: Sergio
authors.initials: S
authors.lastname: Quezada
authors.affiliation: Department of Medical Oncology, Birmingham Heartlands Hospital, Birmingham, United Kingdom.
authors.forename: Gary
authors.initials: G
authors.lastname: Middleton
authors.affiliation: Translational Cancer Therapeutics Laboratory, University College London Cancer Institute, London, United Kingdom.
authors.forename: Elza
authors.initials: E
authors.lastname: de Bruin
authors.affiliation: Cancer Studies and Molecular Medicine, University of Leicester, Leicester, United Kingdom.
authors.forename: John
authors.initials: J
authors.lastname: Le Quesne
authors.affiliation: Translational Cancer Therapeutics Laboratory, University College London Cancer Institute, London, United Kingdom.
authors.forename: Seema
authors.initials: S
authors.lastname: Shafi
authors.affiliation: Department of Pathology, University College London Hospitals, London, United Kingdom.
authors.forename: Mary
authors.initials: M
authors.lastname: Falzon
authors.affiliation: Department of Bioinformatics and BioStatistics, Cancer Research UK, London Research Institute, London, United Kingdom.
authors.forename: Stuart
authors.initials: S
authors.lastname: Horswell
authors.affiliation: Institute of Cancer Studies, University of Manchester and The Christie Hospital, Manchester, United Kingdom.
authors.forename: Fiona
authors.initials: F
authors.lastname: Blackhall
authors.affiliation: Cancer Research UK & UCL Cancer Trials Centre, London, United Kingdom.
authors.forename: Iftekhar
authors.initials: I
authors.lastname: Khan
authors.affiliation: Department of Respiratory Medicine, University College London Hospitals, London, United Kingdom.
authors.forename: Sam
authors.initials: S
authors.lastname: Janes
authors.affiliation: Department of Medical Oncology, Aberdeen University Medical School & Aberdeen Royal Infirmary, Aberdeen, Scotland, United Kingdom.
authors.forename: Marianne
authors.initials: M
authors.lastname: Nicolson
authors.affiliation: Department of Cardiothoracic Surgery, Heart Hospital, London, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Lawrence
authors.affiliation: Department of Medical Oncology, University College London Hospitals, London, United Kingdom.
authors.forename: Martin
authors.initials: M
authors.lastname: Forster
authors.affiliation: Cancer Studies and Molecular Medicine, University of Leicester, Leicester, United Kingdom; Department of Medical Oncology, University of Leicester & Leicester University Hospitals, Leicester, United Kingdom.
authors.forename: Dean
authors.initials: D
authors.lastname: Fennell
authors.affiliation: Department of Medical Oncology, University College London Hospitals, London, United Kingdom.
authors.forename: Siow-Ming
authors.initials: SM
authors.lastname: Lee
authors.affiliation: Department of Clinical Oncology, Velindre Hospital, Cardiff, Wales, United Kingdom.
authors.forename: Jason
authors.initials: J
authors.lastname: Lester
authors.affiliation: Department of Pathology, Aberdeen University Medical School & Aberdeen Royal Infirmary, Aberdeen, Scotland, United Kingdom.
authors.forename: Keith
authors.initials: K
authors.lastname: Kerr
authors.affiliation: Department of Pathology, University of Leicester & Leicester University Hospitals, Leicester, United Kingdom.
authors.forename: Salli
authors.initials: S
authors.lastname: Muller
authors.affiliation: Cancer Research UK & UCL Cancer Trials Centre, London, United Kingdom.
authors.forename: Natasha
authors.initials: N
authors.lastname: Iles
authors.affiliation: Cancer Research UK & UCL Cancer Trials Centre, London, United Kingdom.
authors.forename: Sean
authors.initials: S
authors.lastname: Smith
authors.affiliation: Translational Cancer Therapeutics Laboratory, University College London Cancer Institute, London, United Kingdom; Department of Medical Oncology, University College London Hospitals, London, United Kingdom.
authors.forename: Nirupa
authors.initials: N
authors.lastname: Murugaesu
authors.affiliation: Department of Bioinformatics and BioStatistics, Cancer Research UK, London Research Institute, London, United Kingdom.
authors.forename: Richard
authors.initials: R
authors.lastname: Mitter
authors.affiliation: Department of Bioinformatics and BioStatistics, Cancer Research UK, London Research Institute, London, United Kingdom.
authors.forename: Max
authors.initials: M
authors.lastname: Salm
authors.affiliation: Department of Bioinformatics and BioStatistics, Cancer Research UK, London Research Institute, London, United Kingdom.
authors.forename: Aengus
authors.initials: A
authors.lastname: Stuart
authors.affiliation: The Advanced Sequencing Facility, London Research Institute, London, United Kingdom.
authors.forename: Nik
authors.initials: N
authors.lastname: Matthews
authors.affiliation: Department of Radiology, University Hospital Llandough, Cardiff, Wales, United Kingdom.
authors.forename: Haydn
authors.initials: H
authors.lastname: Adams
authors.affiliation: Department of Medical Oncology, University College London Hospitals, London, United Kingdom.
authors.forename: Tanya
authors.initials: T
authors.lastname: Ahmad
authors.affiliation: Department of Pathology, University Hospital Llandough, Cardiff, Wales, United Kingdom.
authors.forename: Richard
authors.initials: R
authors.lastname: Attanoos
authors.affiliation: Department of Respiratory Medicine, University of Leicester & Leicester University Hospitals, Leicester, United Kingdom.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Bennett
authors.affiliation: Department of Systems Biology, Technical University of Denmark, Kongens Lyngby, Denmark.
authors.forename: Nicolai Juul
authors.initials: NJ
authors.lastname: Birkbak
authors.affiliation: Department of Respiratory Medicine, University Hospital of South Manchester, Manchester, United Kingdom.
authors.forename: Richard
authors.initials: R
authors.lastname: Booton
authors.affiliation: Cancer Research UK Manchester Institute, Manchester, United Kingdom.
authors.forename: Ged
authors.initials: G
authors.lastname: Brady
authors.affiliation: Department of Cardiothoracic Surgery, Aberdeen University Medical School & Aberdeen Royal Infirmary, Aberdeen, United Kingdom.
authors.forename: Keith
authors.initials: K
authors.lastname: Buchan
authors.affiliation: Department of Pathology, University College London Hospitals, London, United Kingdom.
authors.forename: Arrigo
authors.initials: A
authors.lastname: Capitano
authors.affiliation: Department of Respiratory Medicine, Aberdeen University Medical School & Aberdeen Royal Infirmary, Aberdeen, United Kingdom.
authors.forename: Mahendran
authors.initials: M
authors.lastname: Chetty
authors.affiliation: Department of Clinical Immunology, University of Birmingham, Birmingham, B15 2TT.
authors.forename: Mark
authors.initials: M
authors.lastname: Cobbold
authors.affiliation: North West Lung Centre, University Hospital of South Manchester, Manchester, United Kingdom.
authors.forename: Philip
authors.initials: P
authors.lastname: Crosbie
authors.affiliation: Department of Respiratory Medicine, University Hospital Llandough, Cardiff, Wales, United Kingdom.
authors.forename: Helen
authors.initials: H
authors.lastname: Davies
authors.affiliation: Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, United kingdom.
authors.forename: Alan
authors.initials: A
authors.lastname: Denison
authors.affiliation: Department of Radiology, Birmingham Heartlands Hospital, Birmingham, United Kingdom.
authors.forename: Madhav
authors.initials: M
authors.lastname: Djearman
authors.affiliation: Department of IT, London Research Institute, London, United Kingdom.
authors.forename: Jacki
authors.initials: J
authors.lastname: Goldman
authors.affiliation: Independent Cancer Patient's Voice, London, united Kingdom.
authors.forename: Tom
authors.initials: T
authors.lastname: Haswell
authors.affiliation: Department of Pathology, University Hospitals of South Manchester, Manchester.
authors.forename: Leena
authors.initials: L
authors.lastname: Joseph
authors.affiliation: Department of Cardiothoracic Surgery, University Hospital Llandough, Cardiff, Wales, United Kingdom.
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Kornaszewska
authors.affiliation: Cancer Research UK Manchester Institute, Manchester, United Kingdom.
authors.forename: Matthew
authors.initials: M
authors.lastname: Krebs
authors.affiliation: Department of Cellular Pathology, Birmingham Heartlands Hospital, Birmingham, United Kingdom.
authors.forename: Gerald
authors.initials: G
authors.lastname: Langman
authors.affiliation: Independent Cancer Patient's Voice, London, united Kingdom.
authors.forename: Mairead
authors.initials: M
authors.lastname: MacKenzie
authors.affiliation: Department of Respiratory Medicine, Aberdeen University Medical School & Aberdeen Royal Infirmary, Aberdeen, United Kingdom.
authors.forename: Joy
authors.initials: J
authors.lastname: Millar
authors.affiliation: Cancer Studies and Molecular Medicine, University of Leicester, Leicester, United Kingdom.
authors.forename: Bruno
authors.initials: B
authors.lastname: Morgan
authors.affiliation: Department of Thoracic Surgery, Birmingham Heartlands Hospital, Birmingham, United Kingdom.
authors.forename: Babu
authors.initials: B
authors.lastname: Naidu
authors.affiliation: The Christie Hospital, Manchester, United Kingdom; Department of Pathology, University Hospitals of South Manchester, Manchester.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Nonaka
authors.affiliation: Immune Regulation and Tumour Immunotherapy Laboratory, University College London Cancer Institute, London, United Kingdom.
authors.forename: Karl
authors.initials: K
authors.lastname: Peggs
authors.affiliation: Department of Biochemistry, University of Leicester, Leicester, United Kingdom.
authors.forename: Catrin
authors.initials: C
authors.lastname: Pritchard
authors.affiliation: Department of Cardiothoracic Surgery, Aberdeen University Medical School & Aberdeen Royal Infirmary, Aberdeen, United Kingdom.
authors.forename: Hardy
authors.initials: H
authors.lastname: Remmen
authors.affiliation: Translational Cancer Therapeutics Laboratory, London Research Institute, London, United Kingdom.
authors.forename: Andrew
authors.initials: A
authors.lastname: Rowan
authors.affiliation: Department of Cardiothoracic Surgery, University Hospitals of South Manchester, Manchester, United Kingdom.
authors.forename: Rajesh
authors.initials: R
authors.lastname: Shah
authors.affiliation: Department of Radiology, University Hospitals of South Manchester, Manchester, United Kingdom.
authors.forename: Elaine
authors.initials: E
authors.lastname: Smith
authors.affiliation: The Christie Hospital, Manchester, United Kingdom; Department of Medical Oncology, University Hospital of South Manchester, Manchester, United Kingdom.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Summers
authors.affiliation: Department of Radiology, University College London Hospitals, London, United Kingdom.
authors.forename: Magali
authors.initials: M
authors.lastname: Taylor
authors.affiliation: Translational Cancer Therapeutics Laboratory, University College London Cancer Institute, London, United Kingdom.
authors.forename: Selvaraju
authors.initials: S
authors.lastname: Veeriah
authors.affiliation: Department of Cardiothoracic Surgery, University of Leicester & Leicester University Hospitals, Leicester, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Waller
authors.affiliation: School of Cancer Sciences, University of Birmingham, Birmingham, United Kingdom.
authors.forename: Ben
authors.initials: B
authors.lastname: Wilcox
authors.affiliation: Independent Cancer Patient's Voice, London, united Kingdom.
authors.forename: Maggie
authors.initials: M
authors.lastname: Wilcox
authors.affiliation: Department of Respiratory Medicine, Birmingham University Hospital, Birmingham, United Kingdom.
authors.forename: Ian
authors.initials: I
authors.lastname: Woolhouse
authors.affiliation: Translational Cancer Therapeutics Laboratory, London Research Institute, London, United Kingdom.
authors.forename: Nicholas
authors.initials: N
authors.lastname: McGranahan
authors.affiliation: Translational Cancer Therapeutics Laboratory, University College London Cancer Institute, London, United Kingdom; Department of Medical Oncology, University College London Hospitals, London, United Kingdom; Translational Cancer Therapeutics Laboratory, London Research Institute, London, United Kingdom.
authors.forename: Charles
authors.initials: C
authors.lastname: Swanton
mesh_terms: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor / Q000032:analysis; D002289:Carcinoma, Non-Small-Cell Lung / Q000235:genetics*; D018450:Disease Progression; D019008:Drug Resistance, Neoplasm; D006801:Humans; D008137:Longitudinal Studies; D008175:Lung Neoplasms / Q000235:genetics*; D009362:Neoplasm Metastasis; D016896:Treatment Outcome
chemical_list: D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor