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. 2021 Apr;10(4):1792–1803. doi: 10.21037/tlcr-21-48

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2021 Translational Lung Cancer Research. All rights reserved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0.

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Evolutionary change of mutational signatures in primary tumor and metastases. Evolution of the somatic genetic alterations illustrates the changes in mutational processes. The pie chart delineates the proportion of COSMIC mutational signatures. Black, red, and blue lines represent the trunk, the primary LUSC (Pri) and the metastasis (Met) branch, respectively. Branch lengths are proportional to the number of mutations. *This patient received a palliative radiotherapy and chemotherapy (Cisplatin/Vinorelbine and Cisplatin/Gemcitabine) prior to resection of Met 2.