Evidence map›Paper›PMID 23945592›Full record

ArticleNature2013

Signatures of mutational processes in human cancer.

Ludmil B Alexandrov, Serena Nik-Zainal, David C Wedge, Samuel A J R Aparicio, Sam Behjati, Andrew V Biankin, Graham R Bignell, Niccolò Bolli, Ake Borg, Anne-Lise Børresen-Dale and 65 more

Erratum issued 12 registry-linked trialsAbstract read
In one paragraph

Article in Nature, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to 12 registered trials, which are not on this map. Cited by 5,837 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5,837citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02869802 recruitingnot on this mapstarted 2016, after this paper: background citation

Prospectively Defining Metastatic Pancreatic Ductal Adenocarcinoma Subtypes by Comprehensive Genomic Analysis

TypeobservationalSponsorBritish Columbia Cancer AgencyRan2016 to 2027Enrolled190ConditionsCancer, Pancreatic CancerArmsTumour Biopsy, Serial Collection of Plasma and Serum Samples
NCT03044613 phase1active not recruitingnot on this mapstarted 2017, after this paper: background citation

Phase IB Trial of Induction Nivolumab or Nivolumab/Relatlimab Prior to Concurrent Chemoradiation in Patients With Operable Stage II/III Esophageal/ Gastroesophageal Junction Cancer

TypeinterventionalSponsorSidney Kimmel Comprehensive Cancer Center at Johns HopkinsRan2017 to 2027Enrolled32ConditionsGastric Cancer, Esophageal Cancer, GastroEsophageal CancerArmsNivolumab, Relatlimab, Carboplatin, Paclitaxel, Radiation
NCT03835533 phase1completednot on this mapstarted 2019, after this paper: background citation

A Multicenter, Open-Label, Exploratory Platform Study to Evaluate Biomarkers and Immunotherapy Combinations for the Treatment of Patients With Metastatic Castration-resistant Prostate Cancer

TypeinterventionalSponsorParker Institute for Cancer ImmunotherapyRan2019 to 2022Enrolled43ConditionsMetastatic Castration-resistant Prostate CancerArmsNKTR-214 (Cohort A), Nivolumab (Cohort A, B and C), Stereotactic body radiation therapy (SBRT) (Cohort B), CDX-301 (Cohort B and C), Poly-ICLC (Cohort B)
NCT04033965 completednot on this map

Tumor Mutational Patterns and Infiltrating Lymphocyte Density in Young and Old Patients With Breast Cancer

TypeobservationalSponsorHellenic Cooperative Oncology GroupRan1997 to 2010Enrolled345ConditionsBreast CancerArmsCorellation of Mutations, TILs and Age in Breast Cancer
NCT04197219 phase2withdrawnnot on this mapstarted 2021, after this paper: background citation

Pembrolizumab With Axitinib in Recurrent Endometrial Cancer With Deficient Mismatch Repair System Post PD1 Exposure: Phase II Trial

TypeinterventionalSponsorCase Comprehensive Cancer CenterRan2021 to 2026Enrolled0ConditionsRecurrent Endometrial CancerArmsPembrolizumab, Axitinib
NCT04441138 phase2terminatednot on this mapstarted 2021, after this paper: background citation

Phase II Trial of Concurrent, Split Course Chemoradiation Followed by Durvalumab (MEDI4736) in Poor Risk and/or Elderly Patients With Newly Diagnosed Stage III Non-small Cell Lung Cancer

TypeinterventionalSponsorRush University Medical CenterRan2021 to 2024Enrolled10ConditionsStage III Non-small-cell Lung CancerArmsDurvalumab
NCT04696848 phase1 / phase2terminatednot on this mapstarted 2021, after this paper: background citation

A Phase I Study to Determine the Efficacy and Safety of CKD-516 Tablet Combined With Durvalumab(MEDI4736) in Patient Refractory Solid Tumors

TypeinterventionalSponsorTae Won KimRan2021 to 2023Enrolled25ConditionsColorectal Cancer, Solid TumorArmsCKD-516 plus Durvalumab
NCT04765709 phase2terminatednot on this mapstarted 2021, after this paper: background citation

BRIDGE Trial: Phase II Trial of durvalumaB and chemotheRapy Induction Followed by Durvalumab and Radiotherapy in larGe volumE Stage III NSCLC

TypeinterventionalSponsorMario Negri Institute for Pharmacological ResearchRan2021 to 2025Enrolled10ConditionsNon-small Cell Lung Cancer Stage IIIArmsdurvalumab plus platinum-based chemotherapy (cisplatin or carboplatin plus vinorelbine or pemetrexed), Durvalumab plus radiotherapy, durvalumab
NCT05092412 phase2active not recruitingnot on this mapstarted 2022, after this paper: background citation

A First-line Multi-center, Single-arm Exploratory Study Using Low-dose Radiotherapy (LDRT) Combined With Durvalumab (MEDI4736), Etoposide, and Cisplatin/Carboplatin for Patients With Extensive-stage Small Cell Lung Cancer

TypeinterventionalSponsorYou LuRan2022 to 2027Enrolled30ConditionsLung Cancer, Extensive-stage Small-cell Lung Cancer, DurvalumabArmsLow-dose radiotherapy, Durvalumab, Etoposide, and cisplatin/carboplatin
NCT05568212 phase2recruitingnot on this mapstarted 2022, after this paper: background citation

Phase II, Two-cohorts, Randomized Trial Comparing Standard of Care Versus Immune- Based Combination in Relapsed Stage III Non-small-cell Lung Cancer (NSCLC) Pretreated With Chemoradiotherapy and Durvalumab (MEDI4736)

TypeinterventionalSponsorFondazione Ricerca TraslazionaleRan2022 to 2027Enrolled176ConditionsNon-small-cell Lung Cancer PatientsArmsDurvalumab, Olaparib tablet, Single-agent chemotherapy, Platinum doublet chemotherapy
NCT06642506 active not recruitingnot on this mapstarted 2024, after this paper: background citation

Oncometabolome and MALDI-MSI in Upper GI Carcinomas - Chemosensitivity in Esophageal Carcinoma.

TypeobservationalSponsorLudwig-Maximilians - University of MunichRan2024 to 2025Enrolled20ConditionsEsophagus Adenocarcinoma, Esophagus Cancer, Metabolome, Mass Spectrometry
NCT06815497 phase2recruitingnot on this mapstarted 2026, after this paper: background citation

Phase II Non-Randomized, Unblinded, Single-Center Trial of Telmisartan in Combination With Cytotoxic Regimens in Platinum-Resistant Ovarian Cancer Versus Historical Best Supportive Care

TypeinterventionalSponsorTyler J CurielRan2026 to 2029Enrolled33ConditionsOvarian CancerArmsTelmisartan
3 · Its place in the literature

Who cites it

5,837 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
  2. Trial
  3. Trial
  4. Trial
  5. Trial
  6. Trial
  7. Trial
  8. A Phase II Trial of Niraparib in Patients with Advanced Pancreatic Cancer Harboring Pathogenic Variants in ATM, BRCA1, BRCA2, PALB2, and CHEK2.Clinical cancer research : an official journal of the American Association for Cancer Research · 2026
    Trial
  9. Neoadjuvant Nivolumab with or without Ipilimumab for Cisplatin-Ineligible Patients with Muscle-Invasive Bladder Cancer.Clinical cancer research : an official journal of the American Association for Cancer Research · 2026
    Trial
  10. Article
  11. Review
  12. Cadmium inhibits hSMUG1-mediated uracil excision: quantitative analysis and mitigation byJournal of enzyme inhibition and medicinal chemistry · 2026
    Article
  13. Article
  14. Article
  15. Review
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article

5,777 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

75 authors.

Ludmil B AlexandrovCancer Genome Project, Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridgeshire CB10 1SA, UK.
Serena Nik-Zainal
David C Wedge
Samuel A J R Aparicio
Sam Behjati
Andrew V Biankin
Graham R Bignell
Niccolò Bolli
Ake Borg
Anne-Lise Børresen-Dale
Sandrine Boyault
Birgit Burkhardt
Adam P Butler
Carlos Caldas
Helen R Davies
Christine Desmedt
Roland Eils
Jórunn Erla Eyfjörd
John A Foekens
Mel Greaves
Fumie Hosoda
Barbara Hutter
Tomislav Ilicic
Sandrine Imbeaud
Marcin Imielinski
Marcin Imielinsk
Natalie Jäger
David T W Jones
David Jones
Stian Knappskog
Marcel Kool
Sunil R Lakhani
Carlos López-Otín
Sancha Martin
Nikhil C Munshi
Hiromi Nakamura
Paul A Northcott
Marina Pajic
Elli Papaemmanuil
Angelo Paradiso
John V Pearson
Xose S Puente
Keiran Raine
Manasa Ramakrishna
Andrea L Richardson
Julia Richter
Philip Rosenstiel
Matthias Schlesner
Ton N Schumacher
Paul N Span
Jon W Teague
Yasushi Totoki
Andrew N J Tutt
Rafael Valdés-Mas
Marit M van Buuren
Laura van 't Veer
Anne Vincent-Salomon
Nicola Waddell
Lucy R Yates
Australian Pancreatic Cancer Genome Initiative
ICGC Breast Cancer Consortium
ICGC MMML-Seq Consortium
ICGC PedBrain
Jessica Zucman-Rossi
P Andrew Futreal
Ultan McDermott
Peter Lichter
Matthew Meyerson
Sean M Grimmond
Reiner Siebert
Elías Campo
Tatsuhiro Shibata
Stefan M Pfister
Peter J Campbell
Michael R Stratton

Funding

MOLECULAR IMMUNOLOGY AND TUMOR BIOLOGYT32CA009216 · NCI · MASSACHUSETTS GENERAL HOSPITAL · PI David Michael Langenau · 1985 to 2026
$10.6M
NCI NIH HHS T32 CA009216Wellcome Trust 088340Wellcome Trust 093867Wellcome Trust 098051
6 · The paper itself

Abstract

All cancers are caused by somatic mutations; however, understanding of the biological processes generating these mutations is limited. The catalogue of somatic mutations from a cancer genome bears the signatures of the mutational processes that have been operative. Here we analysed 4,938,362 mutations from 7,042 cancers and extracted more than 20 distinct mutational signatures. Some are present in many cancer types, notably a signature attributed to the APOBEC family of cytidine deaminases, whereas others are confined to a single cancer class. Certain signatures are associated with age of the patient at cancer diagnosis, known mutagenic exposures or defects in DNA maintenance, but many are of cryptic origin. In addition to these genome-wide mutational signatures, hypermutation localized to small genomic regions, 'kataegis', is found in many cancer types. The results reveal the diversity of mutational processes underlying the development of cancer, with potential implications for understanding of cancer aetiology, prevention and therapy.

Indexed as

AgingAlgorithmsCell Transformation, NeoplasticCytidine DeaminaseDNADNA Mutational AnalysisHumansModels, GeneticMutagenesisMutagenesis, InsertionalMutagensMutationNeoplasmsOrgan SpecificityReproducibility of ResultsSequence DeletionCytidine DeaminaseDNAMutagens

Identifiers

PMID23945592
PMCPMC3776390

What OpenQuestion holds

Textmetadata
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Read underepoch 390

Registered trials

and 6 more above

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.