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Illustration: Aïda Amer/Axios

An international collaboration of scientists announced Wednesday they have mapped out the cancer genome and also developed a new method of "carbon dating" cancer tumors to determine what and when mutations occurred that led to a person's cancer.

Why it matters: This meta-analysis of the whole genome is the first building block of a knowledge base that the scientists hope will help clinicians determine the precise treatment needed by individual patients — assuming the costs of sequencing and running algorithm programs continue to decline.

Background: Most previous research has focused on the 1% of the cancer genome, or the "exome," which provides instructions for protein coding. This sequencing often reveals one or more mutations — often called driver mutations — which are targetable in roughly two-thirds of patients.

  • But, as Wellcome Sanger Institute's Peter Campbell pointed out, clinicians are often amazed at how two patients with identical tumors would respond to treatments in opposite ways, showing "just how different one person’s cancer genome is from another's."
  • Campbell is a member of the steering committee for the Pan-Cancer Project, which is the decade-long collaboration of over 1,300 scientists and clinicians from 37 countries that helped produce these studies.

What they did: As published in 23 papers in Nature and its related journals, the teams analyzed more than 2,600 genomes of 38 different tumor types, including liver and breast cancer.

  • They created one of the largest resources of primary cancer genomes.
  • They also launched 16 working groups that studied different aspects of cancer's development, causation, progression and classification.

What they found: The researchers discovered they were able to identify about 95% of the tumor samples, and that many have four or five driver mutations that can be targeted. They did not find any drivers for about 5% of the cases.

  • Sequencing both the coding and non-coding portions of the genome allowed them to find many of the small changes that had impact and could be new drug targets, they said.
  • They also increased scientific understanding of the types of pathways involved in specific cancers that can help guide treatment options.

Plus, they developed a way to "carbon date" cancer, or identify mutations that had occurred many years ago that later played a role in cancer forming. From this method, they found about 20% of mutations actually occur years before tumor formation, and that half of these happen in the same nine genes.

  • "It's often years to a decade before they get all of the numbers of mutations required to become a full-grown cancer," Campbell said.
  • It's possible that diagnostics seeking these early mutations could help prevent cancer.

Of note: Two commentaries were published along with the studies.

  • The News & Views piece points out the ability to process hundreds of terabytes of data over millions of hours in multiple data centers was due to cloud computing, saying it's a "prime example of how cloud computing can make international collaboration possible and help to advance data-intensive fields."
  • The Comment piece says the time is now to develop an international code of conduct for data sharing to protect individual's privacy and ensure compliance with developing international laws.

The big picture: This is an important step toward the eventual goal of precise medicine — where a patient's tumor can be sequenced, and combined with consideration of lifestyle and other factors, find a comparable case to better advise treatment regime.

  • The costs of both sequencing and running algorithms need to continue dropping, but Campbell said he hopes "in a few years, this will be much more accessible than now and much more widely used."

Go deeper: Cancer death rates drop by largest amount on record in U.S.

Go deeper

Right-wingers making McCarthy sweat for future Speaker post

House Minority Leader Kevin McCarthy stands with his Republican colleagues outside the House on Nov. 17. Photo: Stefani Reynolds/Bloomberg via Getty Images

Right-wing elements in the Republican Party are complicating House Minority Leader Kevin McCarthy's attempts to become the next speaker of the House should the GOP take back the majority in 2022.

Why it matters: While McCarthy has worked carefully to build trust among the conservatives who tanked his chances at clinching the speakership in 2015, they're still circling ahead of the next Speaker vote in January 2023.

3 hours ago - Politics & Policy

Congress sprints to meet crush of deadlines

Illustration: Aïda Amer/Axios

Congressional leaders have been pushing off vital action for months — and a lot of it will catch up with them in December, which begins Wednesday.

Driving the news: Funding for the federal government is set to expire at midnight on Friday. There are also consequential deadlines related to the debt limit, President Biden's agenda and annual actions like voting on the National Defense Authorization Act.

3 hours ago - World

U.S. fears Iran won’t scale back to 2015 nuclear deal

Officials gather in Vienna on Sept. 29 for the first day of renewed nuclear talks with Iran. Photo: EU Vienna Delegation/Handout/Anadolu Agency via Getty Images

U.S. officials have extremely low expectations as world powers resume negotiations with Iran to curb its nuclear program, believing the Iranians aren't yet ready to negotiate seriously, Axios is told.

Driving the news: Senior officials in the U.S. intelligence community have assessed the new Iranian president, Ebrahim Raisi, thinks of his predecessor, Hassan Rouhani, as a weak accommodationist who negotiated a bad deal with the U.S. and other world powers in 2015.