Fig. 4: Clinical course of the disease and phylogenetic reconstruction of each patient tumor evolution.

A, C Clinical courses of patients Pt2003 and Pt2024 respectively. The main steps of the disease are reported. Metastatic and liquid samples taken in the metastatic setting are reported by dots. Created in BioRender. Desmedt, C. (2025) https://BioRender.com/r3ic3w5, Desmedt, C. (2025) https://BioRender.com/21lpe7w respectively. B, D Phylogenetic reconstructions computed using MEDICC2 based on the copy number events observed on low-pass whole genome sequencing data. Trees are rooted to a diploid ancestor. All liquid and tissue samples that passed the QC and contained tumor are included in the phylogenetic reconstructions, time point of collection is indicated in the first part of the label and can be premortem (DxS: Surgery at diagnosis, MD: metastatic disease) or postmortem (AD: after death). On each branch, genetic distances are reported in red, bootstrap value in blue. Color code is given according to the anatomical position of the tissue samples. Liquid samples are reported in cyan and their label ends by “_Liq”. When multiple samples of the same lesion are taken then a suffix “RgX” or “nX” is added. When samples different tumor of the same area are taken a suffix “LsX” is added. Data are derived from the lpWGS. ASC ascites, CT connective tissue, LN lymph node, L left, liq liquid, LL lower lobe, LN lymph node, lpWGS low-pass whole genome sequencing, P parietal, PFL pleural fluid, QC quality check, R right, RT radiotherapy, SCNA somatic copy number alteration, SLND sentinel lymph node biopsy, ST soft tissue, Th thoracic vertebra, UL upper lobe.