Cancer treatment alters mutant selection in normal esophagus.

Cancer treatment induces treatment-specific mutant selection in normal esophageal epithelium, with TP53 and PPM1D clones expanding after CROSS therapy.

• Why it matters: Understanding how cancer therapies influence mutant clone dynamics in normal tissues is crucial for assessing long-term risks and developing safer treatments.
• What they did: Sequencing normal esophageal tissue from 70 patients post-therapy, including no treatment, chemotherapy, or combined chemo-radiation, to identify mutation patterns and selection.
• The result: Mutant TP53 and PPM1D clones expanded after CROSS, while FLOT therapy increased selection for RAC1, NFE2L2, and MTOR mutations, indicating treatment-specific mutant selection.