Divergent mutational processes distinguish hypoxic and normoxic tumours

PCAWG Consortium

Research output: Contribution to journalArticlepeer-review

71 Scopus citations


Many primary tumours have low levels of molecular oxygen (hypoxia), and hypoxic tumours respond poorly to therapy. Pan-cancer molecular hallmarks of tumour hypoxia remain poorly understood, with limited comprehension of its associations with specific mutational processes, non-coding driver genes and evolutionary features. Here, as part of the ICGC/TCGA Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium, which aggregated whole genome sequencing data from 2658 cancers across 38 tumour types, we quantify hypoxia in 1188 tumours spanning 27 cancer types. Elevated hypoxia associates with increased mutational load across cancer types, irrespective of underlying mutational class. The proportion of mutations attributed to several mutational signatures of unknown aetiology directly associates with the level of hypoxia, suggesting underlying mutational processes for these signatures. At the gene level, driver mutations in TP53, MYC and PTEN are enriched in hypoxic tumours, and mutations in PTEN interact with hypoxia to direct tumour evolutionary trajectories. Overall, hypoxia plays a critical role in shaping the genomic and evolutionary landscapes of cancer.

Original languageAmerican English
Article number737
JournalNature Communications
Issue number1
StatePublished - 1 Dec 2020

Bibliographical note

Funding Information:
The authors gratefully thank Dr. Marianne Koritzinsky for insightful suggestions and thank Jenna E. van Leeuwen for visualization support. The authors also thank all members of the Boutros and Bristow labs for helpful suggestions. We acknowledge the contributions of the many clinical networks across ICGC and TCGA who provided samples and data to the PCAWG Consortium, and the contributions of the Technical Working Group and the Germline Working Group of the PCAWG Consortium for collation, realignment and harmonised variant calling of the cancer genomes used in this study. We thank the patients and their families for their participation in the individual ICGC and TCGA projects. This study was conducted with the support of Movember funds through Prostate Cancer Canada, and with the additional support of the Ontario Institute for Cancer Research, funded by the Government of Ontario. This work was supported by Prostate Cancer Canada and is proudly funded by the Movember Foundation Team Grant T2013 and #RS2014-01. Paul C. Boutros was supported by a Terry Fox Research Institute New Investigator Award, a Prostate Cancer Canada Rising Star Fellowship, a CIHR New Investigator Award, a CIHR Project Grant, the Government of Canada through Genome Canada and the Ontario Genomics Institute (OGI-125), Canadian Cancer Society (grant #705649) and by the University of California. This work has been funded by a fellowship from the Canadian Institutes of Health Research to Vinayak Bhandari. Constance Li was supported by an award from the Government of Ontario. The authors gratefully thank the Princess Margaret Cancer Centre Foundation and Radiation Medicine Programme Academic Enrichment Fund for support (to Robert G. Bristow). This work was supported by a Terry Fox Research Institute Programme Project Grant. Robert G. Bristow is a recipient of a Canadian Cancer Society Research Scientist Award. Laboratory work for R.G.B is supported by the CRUK Manchester Institute through Cancer Research UK. This work was supported by the NIH/NCI through award number P30CA016042.

Publisher Copyright:
© 2020, The Author(s).


Dive into the research topics of 'Divergent mutational processes distinguish hypoxic and normoxic tumours'. Together they form a unique fingerprint.

Cite this