Embryonic origin of cancer in newborn twins
Abstract Studying monozygotic twins who present with identical cancers informs on the developmental origins of childhood tumours. Here, we perform whole genome sequencing on multiple tumour, normal, and placental samples to reconstruct the phylogeny of a soft tissue cancer that spread in utero between monozygotic twins. We demonstrate the origin of the tumour from one twin and time its diversification and transplacental spread to the other twin, showing that the spread occurred only once. This generalisable and scalable approach additionally allows us to dissect the earliest stages of twinning, revealing unexpected asymmetrical contributions of embryonic lineages to the placenta and each twin and challenging the classical model of twinning.
Authors
- Pooja Balasubramanian
- Liina Palm (ORCID: https://orcid.org/0000-0003-3585-2441)
- Simon Hannam (ORCID: https://orcid.org/0000-0001-6663-8224)
- Karin C. M. Straathof (ORCID: https://orcid.org/0000-0001-9673-8568)
- Sarita Depani (ORCID: https://orcid.org/0000-0001-7762-686X)
- Henry Lee-Six (ORCID: https://orcid.org/0000-0003-4831-8088)
- Sadie Baskind
- J. Ciaran Hutchinson (ORCID: https://orcid.org/0000-0002-1708-2634)
- Manàs Dave (ORCID: https://orcid.org/0000-0002-1676-801X)
- Thomas R. W. Oliver (ORCID: https://orcid.org/0000-0003-4306-0102)
- Olga Slater (ORCID: https://orcid.org/0000-0002-5374-6303)
- Sam Behjati (ORCID: https://orcid.org/0000-0002-6600-7665)
- Dyanne Rampling (ORCID: https://orcid.org/0000-0003-3508-8404)
- Tom A. Watson (ORCID: https://orcid.org/0000-0001-6079-3362)
- Nathaniel D. Anderson (ORCID: https://orcid.org/0000-0003-4523-6327)
- Jonathan Kennedy (ORCID: https://orcid.org/0009-0002-4953-4639)
- Barbara Walkowiak (ORCID: https://orcid.org/0009-0007-1722-5897)
- Rohan Verma
Institutions
- University of Cambridge (GB)
- Great Ormond Street Hospital (GB)
- Cambridge University Hospitals NHS Foundation Trust (GB)
- Wellcome Sanger Institute (GB)
- University College London (GB)
Publication Details
- Journal
- Nature Communications
- Published
- 2026-10-06
- DOI
- https://doi.org/10.1038/s41467-026-78178-5
- Primary Topic
- Cancer Genomics and Diagnostics
- Type
- article
- Field-Weighted Citation Impact
- 0.00