Fig. 5: Contributions of signature SBS11 in second (primary) tumors of individuals with CMMRD who were treated with temozolomide (TMZ).

Five individuals in the CMMRD cohort were treated with temozolomide for a total of six primary malignant brain tumors. The cumulative temozolomide dose is indicated for each primary malignant brain tumor. Individual C02 was treated with temozolomide for two primary brain tumors, further increasing the cumulative dose (milligrams (mg)). After variable timeframes following the start of temozolomide treatment, these individuals developed a second primary tumor, or a metastasis (M) or relapse (R) of the primary malignant brain tumor. In these subsequent tumors, the single base substitution (SBS) tumor mutational load (TML) ranges between 5.4 and 214.2 mutations/megabase (mut/Mb) and in two hematological malignancies, SBS11 contributed >35% of mutations to the mutational profile. *Dose administered during a second treatment protocol with temozolomide. Source data are provided as a Source Data file.