{"entity":{"id":"paper-bolton-nat-genet","kind":"paper","name":"Cancer therapy shapes the fitness landscape of clonal hematopoiesis","aka":[],"tldr":"Paper cited by one pathway page, indexed on Europe PMC as PubMed record 33106634 and published in Nature Genetics; the citing page links this DOI, which is how the record was matched.","summary":"Acquired mutations are pervasive across normal tissues. However, understanding of the processes that drive transformation of certain clones to cancer is limited. Here we study this phenomenon in the context of clonal hematopoiesis (CH) and the development of therapy-related myeloid neoplasms (tMNs). We find that mutations are selected differentially based on exposures. Mutations in ASXL1 are enriched in current or former smokers, whereas cancer therapy with radiation, platinum and topoisomerase II inhibitors preferentially selects for mutations in DNA damage response genes (TP53, PPM1D, CHEK2). Sequential sampling provides definitive evidence that DNA damage response clones outcompete other clones when exposed to certain therapies. Among cases in which CH was previously detected, the CH mutation was present at tMN diagnosis. We identify the molecular characteristics of CH that increase risk of tMN. The increasing implementation of clinical sequencing at diagnosis provides an opportunity to identify patients at risk of tMN for prevention strategies.\n\nIndexed on Europe PMC as PubMed record 33106634 (DOI 10.1038/s41588-020-00710-0). Matched by DOI alone: one pathway page cites this DOI among its external links (the pages are listed under Related), and this page was written so that the citation resolves inside OnCo. No figure has been checked by an editor.","asOf":"2026-09-22","links":[{"label":"Nat Genet 2020","url":"https://doi.org/10.1038/s41588-020-00710-0"},{"label":"PubMed","url":"https://pubmed.ncbi.nlm.nih.gov/33106634/"},{"label":"Europe PMC","url":"https://europepmc.org/article/MED/33106634"}],"tags":["europepmc-ingest"],"related":["clonal-haematopoiesis"],"cancers":[],"sections":[],"technologies":[],"targets":[],"drugs":[],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":[],"keyPapers":[],"journals":["nature-genetics"],"dependsOn":[],"notes":[],"journal":"Nature Genetics","year":2020,"doi":"10.1038/s41588-020-00710-0","pmid":"33106634","authors":"Bolton KL, Ptashkin RN, Gao T, et al.","paperType":"observational","findings":[],"whatItMeans":"One pathway page on OnCo cites this paper by its DOI; this record gives the citation a page of its own so a reader can follow it without leaving OnCo. Read the abstract above alongside the citing page listed under Related; the record was created automatically from the Europe PMC entry and its figures have not been checked by hand.","caveats":["Matched to the citing OnCo records by DOI alone; the summary reproduces the Europe PMC abstract and no figure has been verified against the full paper."]},"route":"/key-papers/paper-bolton-nat-genet/","neighbours":{"pathway":[{"id":"clonal-haematopoiesis","kind":"pathway","name":"Clonal haematopoiesis (CHIP)","route":"/pathways/clonal-haematopoiesis/"}],"journal":[{"id":"nature-genetics","kind":"journal","name":"Nature Genetics","route":"/journals/nature-genetics/"}]}}