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IMMORTALITY
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Cancer By Genes, Mutations
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🧬 The “Cancer Gene Universe” in Numbers, if we chart all known cancer drivers: # 300 genes are implicated in cancer # 60 genes are major recurrent drivers # 15 genes cause the majority of cancers # TP53, KRAS, PIK3CA, APC, PTEN, BRAF are the global heavy hitters Legend: TSG = Tumor suppressor gene, OG = Oncogene, DR = DNA repair {pre} | Gene | % of Cancers | Category | Notes | | ---------------- | ------------ | -------- | ------------------------------------------ | | **TP53** | **~50%** | TSG | Most common driver mutation in all cancers | | **KRAS** | **25%** | OG | Dominant in pancreatic, lung, colon | | **PIK3CA** | **14%** | OG | Breast, gynecologic, colon | | **APC** | **10%** | TSG | Initiator of colorectal cancer | | **PTEN** | **9%** | TSG | Many solid tumors | | **BRAF** | **7%** | OG | Melanoma, thyroid | | **RB1** | **7%** | TSG | Retinoblastoma, lung | | **NF1** | **5%** | TSG | Nervous system tumors, others | | **ATM** | **5%** | DR | DNA damage response | | **IDH1/2** | **4%** | OG | Glioma, leukemia | | **CDKN2A** | **4%** | TSG | Melanoma, pancreatic | | **EGFR** | **4%** | OG | Lung cancer | | **SMAD4** | **4%** | TSG | Pancreatic, colon | | **ERBB2 (HER2)** | **3%** | OG | Breast, gastric | | **NOTCH1** | **3%** | OG/TSG | Common in leukemias | | **NFE2L2** | **3%** | OG | Esophageal, lung | | **CTNNB1** | **3%** | OG | Liver, colon, endometrial | | **ALK** | ~2% | OG | Lung, lymphoma | | **ROS1** | ~1% | OG | Lung | | **MET** | ~1–2% | OG | Lung, kidney | | **RET** | ~1–2% | OG | Thyroid, lung | | **MYC** | ~1–2% | OG | Many aggressive cancers | | **TERT promoter** | ~2–3% | Regulation | Important in brain, bladder, liver cancers | | **FAT1** | ~2% | TSG | Squamous cancers | | **ARID1A** | ~2–3% | TSG | Ovarian, gastric | | **BRCA1** | ~1% | DR | Breast, ovarian, prostate | | **BRCA2** | ~2% | DR | Breast, prostate, pancreatic | | **MLH1** | ~1% | DR | Colon & endometrial | | **PMS2, MSH2, MSH6** | each ~1% | DR | MSI-high cancers | | **FOXL2** | <1% | Ovarian granulosa tumors | | **KIT** | <1–2% | Melanoma & GIST | | **GNAQ/GNA11** | <1% | Uveal melanoma | | **EWSR1 fusions** | rare | Ewing sarcoma | | **SS18 fusions** | rare | Synovial sarcoma | | **NPM1** | <1% overall (but ~30% AML) | Leukemia | | **FLT3** | <1% overall (but 25% AML) | Leukemia | | **RUNX1** | <1% overall | Leukemia | | **HOXB13** | <1% | Prostate | | **VHL** | <1% overall | Kidney cancer | | **TERT promoter** | varies | Brain, liver, thyroid, melanoma | {/pre} {pre} | # | Cancer Type | Key Mutated Genes / Pathways | | ------ | ------------------------------------- | ------------------------------------------------------- | | **1** | **Glioblastoma (GBM)** | TERT promoter, EGFR, PTEN, TP53, IDH-wildtype | | **2** | Lower-Grade Glioma | IDH1, IDH2, 1p/19q codeletion, TP53, ATRX | | **3** | Medulloblastoma | CTNNB1, PTCH1, SMO, MYC, MYCN | | **4** | Meningioma | NF2, TRAF7, KLF4, AKT1, SMO | | **5** | Ependymoma | ZFTA–RELA fusions, NF2 | | **6** | **Lung Adenocarcinoma** | EGFR, KRAS, ALK, ROS1, BRAF, MET, RET, ERBB2 | | **7** | Lung Squamous Cell | TP53, CDKN2A, PTEN, NFE2L2, PIK3CA | | **8** | Small-Cell Lung Cancer | TP53, RB1, MYC amplification | | **9** | **Breast (general)** | PIK3CA, BRCA1/2, TP53, HER2 (ERBB2), GATA3 | | **10** | Triple-Negative Breast | BRCA1-like profile, TP53, RAD51, PTEN loss | | **11** | HER2+ Breast | ERBB2 amplification, PIK3CA | | **12** | Colorectal Cancer | APC, KRAS, TP53, BRAF V600E, SMAD4, MLH1/MSH2/MSH6/PMS2 | | **13** | Gastric Cancer | CDH1, TP53, ARID1A, PIK3CA, ERBB2 | | **14** | Esophageal Adenocarcinoma | TP53, ERBB2, SMAD4, CDKN2A | | **15** | Esophageal Squamous | TP53, NOTCH1, PIK3CA, NFE2L2 | | **16** | **Pancreatic Ductal Adenocarcinoma** | KRAS (>90%), CDKN2A, TP53, SMAD4 | | **17** | Ampullary Cancer | KRAS, TP53, APC | | **18** | Liver (Hepatocellular) | TERT promoter, TP53, CTNNB1, AXIN1 | | **19** | Cholangiocarcinoma | IDH1/2, FGFR2 fusions, KRAS, BAP1 | | **20** | Gallbladder Cancer | TP53, KRAS, ERBB2, ARID1A | | **21** | **Prostate Cancer** | TMPRSS2–ERG fusion, PTEN, BRCA2, SPOP | | **22** | Bladder Cancer | TERT promoter, FGFR3, TP53, RB1 | | **23** | Kidney (Clear-Cell RCC) | VHL, PBRM1, SETD2, BAP1 | | **24** | Kidney (Papillary RCC) | MET, FH, NF2 | | **25** | Wilms Tumor | WT1, WTX, CTNNB1 | | **26** | Ovarian High-Grade Serous | TP53, BRCA1/2, CCNE1 | | **27** | Ovarian Clear Cell | ARID1A, PIK3CA | | **28** | Endometrial Cancer | PTEN, PIK3CA, KRAS, POLE, MLH1 | | **29** | Cervical Cancer | HPV E6/E7 (inactivates TP53 and RB1) | | **30** | Vulvar Cancer | TP53 or HPV-related alterations | | **31** | Testicular Germ Cell Tumor | KIT, KRAS, NRAS, isochromosome 12p | | **32** | Penile Cancer | TP53, HRAS, HPV E6/E7 | | **33** | **Melanoma (cutaneous)** | BRAF V600E, NRAS, NF1 | | **34** | Melanoma (acral/mucosal) | KIT, NF1, BRAF (less frequent) | | **35** | Uveal Melanoma | GNAQ, GNA11, BAP1 | | **36** | Basal Cell Carcinoma | PTCH1, SMO (Hedgehog pathway) | | **37** | Squamous Cell Carcinoma (skin) | TP53, NOTCH1/2, CDKN2A | | **38** | Merkel Cell Carcinoma | MCPyV integration OR TP53/RB1 mutations | | **39** | **Acute Myeloid Leukemia (AML)** | FLT3, NPM1, IDH1/2, RUNX1, TP53 | | **40** | Acute Lymphoblastic Leukemia (ALL) | BCR-ABL1, ETV6-RUNX1, MLL rearrangements | | **41** | Chronic Myeloid Leukemia (CML)** | BCR-ABL (Philadelphia chromosome) | | **42** | Chronic Lymphocytic Leukemia (CLL)** | TP53, ATM, NOTCH1, SF3B1 | | **43** | Hodgkin Lymphoma | PD-L1/PD-L2 amplifications, JAK2 | | **44** | Non-Hodgkin Lymphomas | BCL2, BCL6, MYC rearrangements | | **45** | Multiple Myeloma | IgH translocations, MYC, KRAS, NRAS | | **46** | **Osteosarcoma** | TP53, RB1, ATRX | | **47** | Ewing Sarcoma | EWS–FLI1 fusion | | **48** | Synovial Sarcoma | SS18–SSX fusion | | **49** | Rhabdomyosarcoma | PAX3–FOXO1 fusion (alveolar) | | **50** | Gastrointestinal Stromal Tumor (GIST) | KIT, PDGFRA | | **51** | Neuroblastoma | ALK mutations, MYCN amplification | | **52** | Thyroid Papillary | BRAF V600E, RET/PTC, NTRK fusions | | **53** | Thyroid Follicular | RAS mutations, PAX8–PPARG | | **54** | Thyroid Medullary | RET mutations | | **55** | Parathyroid Cancer | CDC73 | | **56** | Adrenal Cortical Carcinoma | TP53, CTNNB1, IGF2 | | **57** | Pheochromocytoma | RET, VHL, SDHB/D, NF1 | | **58** | Mesothelioma | BAP1, NF2, CDKN2A | | **59** | Thymoma / Thymic Carcinoma | GTF2I, KIT, TP53 | | **60** | Salivary Gland Cancers | MYB–NFIB (adenoid cystic), ETV6–NTRK3 | | **61** | Head & Neck Squamous Cancer | TP53, CDKN2A, NOTCH1, HPV E6/E7 (subset) | {/pre}
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