Multiregional Sequencing of IDH-WT Glioblastoma Reveals High Genetic Heterogeneity and a Dynamic Evolutionary History

Glioblastoma is one of the most common and lethal primary neoplasms brain. Patient survival has not improved significantly over past three decades patient median just year. Tumor heterogeneity thought to be a major determinant therapeutic failure reason for poor overall survival. This work aims comprehensively define intra- inter-tumor by mapping genomic mutational landscape multiple areas IDH wild-type (IDH-WT) glioblastomas. Using whole exome sequencing, we explored how copy number variation, chromosomal single loci amplifications/deletions, burden are spatially distributed across nine different tumor regions. The results show that all tumors exhibit signature despite same diagnosis. Above all, high emerges. evolutionary dynamics identified mutations within each region underline questionable value biopsy thus approach patient. Multiregional collection subsequent sequencing essential try address clinical challenge precision medicine. Especially in glioblastoma, this could provide powerful support pathologists oncologists evaluating diagnosis defining best treatment option.