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The incidence of bladder cancer and patient survival vary greatly among different populations. Still, the influence of the associated molecular features and evolutionary processes on its clinical treatment and prognostication remains unknown. The prevalence of TP53 and ATM clonal mutations, as well as the associated burden of SCNAs, is significantly higher in Whites/Blacks than Asians. The authors identify a trans‐ancestry prognostic subtype of bladder cancer characterized by: the enrichment of non‐muscle‐invasive patients and muscle‐invasive patients with good prognosis, increased CREBBP/FGFR3/HRAS/NFE2L2 mutations, decreased intra‐tumor heterogeneity and genome instability and an activated tumor microenvironment.
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