Basic CMYK

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K021 SETD2 f.shift del. K021 PBRM1 stopgain nsSNV. K354 VHL f.shift ins. K375 VHL f.shift del. K255 PTEN stopgain nsSNV. K107 BAP1 splicing. K107 VHL ...
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Clonal copy neutral allelic imbalance (CNAI) in relation to clonal mutations K021 SETD2 f.shift del K021 PBRM1 stopgain nsSNV K354 VHL f.shift ins K107 BAP1 splicing K375 VHL f.shift del K107 VHL f.shift del.

K255 PTEN stopgain nsSNV

5

All regions affected by either copy copy neutral allelic imbalance or loss relative to ploidy All regions affected by copy neutral allelic imbalance

1p 1q 2p 2q 3p 3q 4p 4q 5p 5q 6p 6q 7p 7q 8p 8q 9p 9q 10p 10q 11p 11q 12p 12q 13q 14q 15q 16p 16q 17p 17q 18p 18q 19p 19q 20p 20q 21q 22q

0

K354 K375 K253 K099 K379 K158 K446 K255 K250 K119 K107 K064 K328 K263 K245 K208 K066 K021 K376 K256 K252 K239 K222 K065 K139 K096 K463 K444 K427 K386 K326 K323 K308 K306 K304 K280 K265 K242 K217 K216 K207 K184 K177 K167 K162 K156 K150 K145 K143 K138 K135 K130 K128 K104 K098 K097 K071 K070 K039 K032 K029 K027 K023 K523 K520 K450 K448 K390 K360 K357 K352 K334 K276 K272 K249 K243 K237 K234 K233 K229 K228 K226 K220 K206 K191 K182 K180 K176 K169 K165 K163 K153 K136 K124 K123 K118 K114 K110 K105 K079 K059

0

1p 1q 2p 2q 3p 3q 4p 4q 5p 5q 6p 6q 7p 7q 8p 8q 9p 9q 10p 10q 11p 11q 12p 12q 13q 14q 15q 16p 16q 17p 17q 18p 18q 19p 19q 20p 20q 21q 22q

Events

K066 MTOR nsSNV

The top panel of this figure is bar chart depicting the number of ubiquitous (present in all regions sequenced for a patient) copy neutral allelic imbalance (CNAI) events in dark blue and the number of ubiquitous CNAI/loss in the cohort for all chromosome arms is indicated in light blue. Patients with co-occurring clonal mutations on these chromosomal arms are shown by lines to the corresponding chromosome arms. The bottom panel is a heatmap indicating which patients’ disease from the cohort have either ubiquitous CNAI events (dark blue) or ubiquitous CNAI/loss events (light blue).

Patient K059 1

2

3

4

5

6

Chromosome 7

8

9

10

11 12

13 14 15 16 17 1819 202122

Region BAF

R13

R2

R7

B-allele frequency profile of heterozygous SNPs across the genome (chromosomes 1-22) from all regions obtained from the multi-region whole genome sequencing from the patient’s disease. Sections of BAF in regions that have mirrored subclonal allelic imbalance are highlighted in blue or orange. This legend applies to the ther patient specific figures of the same format in this document.

Patient K071 1

R1

R2

Region BAF

R3

R4

R7

R8

2

3

4

5

6

Chromosome 7

8

9

10

11 12

13 14 15 16 17 1819 202122

Patient K099 1

R1

R2

Region BAF

R3

R4

2

3

4

5

6

Chromosome 7

8

9

10

11 12

13 14 15 16 17 1819 202122

Patient K104 focal chr8:30242747-47499801

LogR

2

1 0 -1 -2

2

-3

R11 BAF

0.7 0.3

LogR

2

1 0 -1 -2

2

-3

R1 BAF

0.7 0.3

LogR

2

1 0 -1 -2

32 1

-3

R2 BAF

0.7 0.3

LogR

2

1 0 -1 -2

6 2 1

-3

R3 BAF

0.7 0.3

Shows the BAF and LogR (log ratio of the relative levels of sequencing coverage in the tumor region versus the germline normal) profile across part of chromosome 8 for all regions of the tumor samples that underwent whole exome sequencing from patient’s disease. Each region has a plot of LogR below with the total copy number assigned to each segment on right of the plot, it also has a BAF plot below. The BAF in regions that have mirrored subclonal allelic imbalance are highlighted in blue or orange. This legend applies to the ther patient specific figures of the same format in this document.

Patient K107 1

R6

Region BAF

R7

R8

R9

R10

R11

2

3

4

5

6

Chromosome 7

8

9

10

11 12

13 14 15 16 17 1819 202122

Patient K143 1

Region BAF

R1

R2

R3

2

3

4

5

6

Chromosome 7

8

9

10

11 12

13 14 15 16 17 1819 202122

Patient K150 1

Region BAF

R1

R2

R3

2

3

4

5

6

Chromosome 7

8

9

10

11 12

13 14 15 16 17 1819 202122

BAF

0.7

0.3

Patient K153 chr8 chr8:54000135-55281514

2

LogR

1 0

2 1

-1

BAF

R48 0.7

0.3

2

LogR

1 0

2 1

-1

R54 BAF

0.7

0.3

LogR

2 1 0 -1

BAF

R57 0.7

0.3

2 1

Patient K161 1

R1

R2

R3

R4

Region BAF

R5

R6

R7

R8

R9

R10

2

3

4

5

6

Chromosome 7

8

9

10

11 12

13 14 15 16 17 1819 202122

Patient K162 1

R4

Region BAF

R6

R7

Normal

2

3

4

5

6

Chromosome 7

8

9

10

11 12

13 14 15 16 17 1819 202122

Patient K163 1

R4

Region BAF

R21

R5

Normal

2

3

4

5

6

Chromosome 7

8

9

10

11 12

13 14 15 16 17 1819 202122

1.5

LogR

1

0.5 0

Patient K167 focals chr11:66414915-67923282 chr11:71963129-73780167 3 2

-0.5 -1

R11 BAF

0.7 0.3 1.5

LogR

1

0.5

R1

0

3

-0.5 -1

BAF

0.7

1

0.3

1.5

LogR

1

0.5 0

2

-0.5

R7

-1

BAF

0.7 0.3 1.5

LogR

1

0.5 0

-0.5 -1 0.7

BAF

N

0.3

2

Patient K169 1

Region BAF

R14

R2

R7

2

3

4

5

6

Chromosome 7

8

9

10

11 12

13 14 15 16 17 1819 202122

4

Patient K169 focal chr8:46876986-47377780

3

LogR

2 0 -1

14 8 4 2 1

-2

R14 BAF

1

0.7

0.3 4 3

LogR

2 1 0 -1 -2

BAF

R2

15 10 4 3 2 1

0.7

0.3

4 3

LogR

2 1 0 -1

15 4 2 1

-2

R7 BAF

0.7

0.3

4

LogR

3 2 1 0 -1 -2

BAF

R1

0.7

0.3

12 4 2 1

Patient K178 1

R1

R2

Region BAF

R3

R4

R5

R6

R7

2

3

4

5

6

Chromosome 7

8

9

10

11 12

13 14 15 16 17 1819 202122

Patient K180 1

R25

Region BAF

R30

R6

Normal

R9

2

3

4

5

6

Chromosome 7

8

9

10

11 12

13 14 15 16 17 1819 202122

MSAI Summary

14q loss allele A

A

Most recent common ancestor

14q loss allele B

0.7 BAF 0.3

intermediate clone

tumorigenesis

VHL PBRM1

tumor region 2:

0.7 BAF 0.3

K059 K169

D)

C)

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16 17 18 19 20 2122

R7 BAF

1

0.3

0

0.7

1

0.3

0

0.7

1

0.3

0

R2 BAF

0.7

1

0.3

0

K143

2

# losses

R13 BAF

MSAI parallel gain MSAI parallel loss/LOH

R2 BAF

0.7

R1 BAF

0.7

0.3

0.3

K180

1 0

R13 BAF

0.7

1 0

R6 BAF

0.7

1 0

0.3

1 0

0.3

4

3

K059

0.7

1

0

# gains

1

R2 BAF

1

14q loss allele A

B)

tumor region 1:

chr14

chr14

A) Shows a schematic of how a parallel copy number losses could result in mirrored subclonal allelic imbalance (MSAI). This occurs when the maternal allele is gained or lost in a subclone in one region and the paternal allele is gained or lost in a different subclone in another region. In the schematic the entire paternal (blue) chromosome is lost in R1 leading to the allelic imbalance seen in B-allele frequency (BAF) plot with the heterozygous SNPs’ from the paternal (blue) chromosome having higher BAF values. In R2 the q arm of the maternal (orange) chromosome is lost leading to isolated allelic imbalance in the plot to the right with the heterozygous SNPs originating from q arm paternal q arm having higher BAF values. B) Phylogenetic tree indicating the subclonal loss of 14q from different alleles in the three regions that underwent whole genome sequencing. C) Shows the genomic position and size of all MSAI events found in the multi-region exome and multi-region whole genome sequencing performed in this study. This includes MSAI events that result from heterogeneous gains and losses relative to ploidy in same patient’s disease. MSAI parallel loss of 14q is the most common event. D) shows the B-allele frequency (BAF) plots of two regions from each patient’s disease that demonstrates MSAI through parallel loss relative to ploidy and loss of heterozygosity in chromosome 14.

PCR fragment analysis using microsatellite marker D14S306 validating subclonal loss and MSAI (R19) in patient K280. Each number following the patient identifier indicates a tumor region and the germline is indicated by a ‘B’.

MSAI validation

PCR fragment analysis using microsatellite marker D14S306 validating subclonal loss and MSAI (R4, R8 & R14) in patient K243.

K265 (Primary tumour 1: R1, R3; Primary tumour 2: R5 - R8)

K334 (Left primary tumour: R11 - R13; Right primary tumour: R1, R5 - R8)

K352 (Primary tumour 1: R1, R2, R3; Primary tumour 2: R4, R5, R6)

K097 (Left primary tumour: R1-R3; Right primary tumour: R101, R102)

K114 (Left primary tumour: R1 – R4; Right primary tumour: R101 – R103)

.