“…By contrast, the genomic features of recurrent disease ( Fig. 2, Table S6) were notable for somatic alterations in additional genes, some of which are predicted to or likely to activate Mapk/Erk signaling (G12V mutation in KRAS, I679Dfs*21 mutation in NF1, R111X mutation in PPP6C) (23,24), PI3K/Akt/MTOR signaling (D323H hotspot mutation in AKT1, E542K hotspot mutation in PIK3CA, homozygous deletion of STK11) (25), or MYC/MAX regulated gene expression (Y1312X mutation in CHD8, W1004X mutation in MGA, X863_ splicing mutation in NOTCH1, up to 16-fold amplification of MYC) (26,27). Somatic alterations in genes predicted to affect chromatinmediated gene expression (up to 38-fold focal amplification of HIST1H3B, frameshift mutations in KMT2B, KMT2C, KMT2D, c.4471-1N>A splicing mutations in TRIP12) (28)(29)(30), nuclear export (E571K hotspot mutation in XPO1) (31) and DNA damage repair (c.497-1N>A splicing mutation in ATM, F134V mutation in TP53) were also found (32,33).…”