Single-cell phylogenies reveal deviations from clock-like, neutral evolution in cancer and healthy tissues

Abstract How tumors evolve affects cancer progression, therapy response, and relapse. However, whether tumor evolution is driven primarily by selectively advantageous or neutral mutations remains under debate. Resolving this controversy has so far been limited by the use of bulk sequencing data. Here, we leverage the high resolution of single-cell DNA sequencing (scDNA-seq) to test for clock-like, neutral evolution. Under neutrality, different cell lineages evolve at a similar rate, accumulating mutations according to a molecular clock. We developed and benchmarked a test of the somatic clock based on single-cell phylogenies and applied it to 22 scDNA-seq datasets. We rejected the clock in 10/13 cancer and 5/9 healthy datasets. The clock rejection in seven cancer datasets could be related to known driver mutations. Our findings demonstrate the power of scDNA-seq for studying somatic evolution and suggest that some cancer and healthy cell populations are driven by selection while others seem to evolve under neutrality.