Molecular and clonal evolution in vivo reveal a common pathway of distant relapse gliomas

The evolutionary trajectories of genomic alterations that occur in the distant progression of glioma remain largely unknown. To elucidate glioma evolution, we inferred the evolutionary trajectories of matched pairs of primary tumors and relapse tumors or tumor in situ fluid (TISF) based on deep whole-genome sequencing data (ctDNA).We collected longitudinal genomic profiles of 32 glioma samples and their matched TISF samples after the initial surgery under sstress treatment.Our study demonstrated evolution trajectories differed markedly in distinct glioma subtypes with variant relapse patterns based on analysis of ctDN.