Publications

The provocative findings by Pich et al. (Apr. 24 issue)¹ showing the influence of tumor-infiltrating clonal hematopoiesis (TI-CH) on patient outcomes in early-stage cancers support the clinical significance of identifying the presence and origin of nontumoral somatic alterations in patients with cancer. At the same time, detection of clonal hematopoiesis mutations has hampered clinical interpretation of next-generation sequencing (NGS) results, because clonal hematopoiesis alterations can be mistaken as being tumor-derived, confounding clinical decisions.^2,3 Using a subset of 3255 patients with late-stage cancer with matched blood and tissue NGS results from a large pan-cancer biorepository comprising more than 500,000 tumor samples, we confirmed the high prevalence of TI-CH in a variety of common solid tumors (Figure 1A) as well as the negative prognostic effect of TI-CH detection on survival (Figure 1B). The original report by Pich et al., together with our independent validation presented here, suggest that patients with cancer who are undergoing comprehensive genomic profiling would benefit from concurrent tumor and clonal hematopoiesis profiling to enable disambiguation of tumor-derived from clonal hematopoiesis–derived genetic alterations and to better inform precision therapeutics.