Molecular heterogeneity and early metastatic clone selection in testicular germ cell cancer development

Four rare cases of primary therapy-resistant nonseminoma (NS) were studied using whole genome sequencing (WGS) on the primary cancer and targeted sequencing analyses on 42 enriched histological components, precursor cell populations and metastatic lesions after treatment. In particular, focus was on the early events of tumor formation, the molecular heterogeneity within the primary tumor and the retention of molecular markers in the metastatic recurrences. Additionally, RNA expression (RNAseq) and high throughput DNA methylation data (including derivated copy number variation analyses) were integrated in the bioinformatics analysis to understand the crucial steps in the process of disease progression.