Genomic heterogeneity as a barrier to precision oncology in urothelial cancer

Clinton et al. define the concordance of genomic alterations in urothelial carcinoma from a localized to metastatic state to identify drivers of progression. Within individual patients, there is significant discordance between primary and metastatic sites. Additionally, plasma cell-free DNA (cfDNA) can identify alterations not detected by tumor sequencing.

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