Whilst Andreas Sottoriva and Trevor Graham's method for identifying neutrally evolving tumours, introduced in https://www.ncbi.nlm.nih.gov/pubmed/26780609, is still being debated, I wonder if there might be scope or interest in applying this ti the GLASS data for inclusion in the initial publication? As a preliminary inspection, I downloaded the mutation calls and, using the threshold suggested in the paper (0.12<=vaf<=0.24), applied the method to indicate which gliomas evolved neutrally in the lead up to, or following, treatment ( for each of the 201 pairs where data for the primary (TP) and first recurrence (R1) are available). This indicated that 41 primary tumours (~20%) and 41 recurrent tumours (~20%) met the requirement for neutrality (Rsquared>0.98) - and in 12 patients both their primary and recurrent tumour were labelled as neutrally evolving by this method. In the paper above it was shown that no GBMs met the requirement to indicate neutral evolution - but there were only 4 included. This would be a more thorough inspection and though would require further analysis: 1) Might be necessary to do the analyses in more depth (as per the original publication) to see, for example, how copy number affects the findings 2) The group have since shown that multi-region sampling is a better indicator of whether the tumour as a whole is evolving neutrally - are there sufficient multi-region samples in this dataset to inspect this? 3) Do neutrally evolving primaries do better/worse in terms of PFS or OS? etc etc But could potentially spark interesting discussion: 1) Neutral evolution indicates that the tumour cells have 'everything they need' to exhibit their phenotype - in these cases would it only be effective to therapeutically target clonal mutations because subclonal ones, even if usually though to be driver mutations, are not causing a selective advantage (i.e. this could be relevant for clinical trials for new targeted therapies: if the patient's tumour was shown to be neutrally evolving, would/should the presence of the mutation targeted by the trial drug be sufficient for that patent's inclusion IF the targetted mutation was found to be subclonal?) 2) If we have neutrally evolving primary tumours but non-neutral recurrences, are these the best pairs to inspect to identify candidate treatment-resistance conferring mutations (.e. those which dominate post-treatment because they were selected for during therapy specifically)? 3) Conversely, in cases where the primary is not evolving neutrally but the recurrence is, does that indicate that the clonal mutations in the recurrence are the best candidates for conferring resistance as a potential selective sweep caused by treatment has left the tumour with all it needs to continue; accumulating mutations linearly with no selective (dis)advantage? Just some food for thought...

Created by Lucy Stead LucyFStead
Agreed that it would be great to have a further discussion on this at an upcoming call. This might also include what we might be able to take away from the analysis: does neutral evolution matter? What do we take away from this knowledge? Alternatively: do we see a difference in the proportion of samples with evidence for neutral evolution, by not only IDH/codel subtype but also by treatment status? I.e. do chemotherapy and radiation impose evolutionary bottlenecks?
Thanks for your thought-provoking post Lucy! Your early neutral evolution results are certainly interesting and it would be great to see them further expounded upon. Please let us know how we can support these efforts and whether any clarification about the GLASS data is needed to make progress. In addition to the paper you shared, there does seem to be a few subclonal selection methodological updates/considerations: https://www.ncbi.nlm.nih.gov/pubmed/28854177 and https://www.ncbi.nlm.nih.gov/pubmed/29808029. Application of the new method detailed in Williams et al. Nature Genetics 2018 suggests that we may observe an even greater proportion of neutrally evolving tumors. As discussed at the end of their manuscript: ``` Our previous analysis (Williams et al. Nature Genetics 2016) suggested that neutral dynamics were rejected in a higher percentage of colon cancers (approximately 65%) than the 21% reported here. The discrepancy is explained by the stochasticity in the evolutionary process, where chance events can lead to deviations from the neutral 1/f distribution. Unlike our previous analytic derivation, the Bayesian model selection framework presented here captures this stochasticity (and hence neutral evolution is preferred in a greater proportion of samples). ``` To answer your question about multi-sector analyses, we currently have roughly 19 GLASS subjects for which multi-sector data exists. We will provide a flag for whether the analysis is longitudinal or multi-sector in future data releases to make this information easier to find, though it could be determined by identifying multiple samples at the same surgical time point. Unfortunately, GLASS doesn't currently have information about the spatial location of these multi-sector samples. It would be great to revisit all the hypotheses you posed above once we have a more in-depth analysis of the neutral evolving tumors. Perhaps in this discussion forum or in an upcoming GLASS teleconference?

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