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Ongoing genome doubling shapes evolvability and immunity in ovarian cancer

Andrew McPherson
Ignacio Vázquez-García
Matthew A. Myers
Duaa H. Al-Rawi
Matthew Zatzman
Adam C. Weiner
Samuel Freeman
Neeman Mohibullah
Gryte Satas
Marc J. Williams
Nicholas Ceglia
Danguolė Norkūnaitė
Allen W. Zhang
Jun Li
Jamie L. P. Lim
Michelle Wu
Seongmin Choi
Eliyahu Havasov
Diljot Grewal
Hongyu Shi
Minsoo Kim
Roland F. Schwarz
Tom Kaufmann
Khanh Ngoc Dinh
Florian Uhlitz
Julie Tran
Yushi Wu
Ruchi Patel
Satish Ramakrishnan
DooA Kim
Justin Clarke
Hunter Green
Emily Ali
Melody DiBona
Nancy Varice
Ritika Kundra
Vance Broach
Ginger J. Gardner
Kara Long Roche
Yukio Sonoda
Oliver Zivanovic
Sarah H. Kim
Rachel N. Grisham
Ying L. Liu
Agnes Viale
Nicole Rusk
Yulia Lakhman
Lora H. Ellenson
Simon Tavaré
Samuel Aparicio
Dennis S. Chi
Carol Aghajanian
Nadeem R. Abu-Rustum
Claire F. Friedman
Dmitriy Zamarin
Britta Weigelt
Samuel F. Bakhoum & Sohrab P. Shah

July 15, 2025

Whole-genome doubling (WGD) is a common feature of human cancers and is linked to tumour progression, drug resistance, and metastasis1,2,3,4,5,6. Here we examine the impact of WGD on somatic evolution and immune evasion at single-cell resolution in patient tumours. Using single-cell whole-genome sequencing, we analysed 70 high-grade serous ovarian cancer samples from 41 patients (30,260 tumour genomes) and observed near-ubiquitous evidence that WGD is an ongoing mutational process. WGD was associated with increased cell–cell diversity and higher rates of chromosomal missegregation and consequent micronucleation. We developed a mutation-based WGD timing method called doubleTime to delineate specific modes by which WGD can drive tumour evolution, including early fixation followed by considerable diversification, multiple parallel WGD events on a pre-existing background of copy-number diversity, and evolutionarily late WGD in small clones and individual cells. Furthermore, using matched single-cell RNA sequencing and high-resolution immunofluorescence microscopy, we found that inflammatory signalling and cGAS-STING pathway activation result from ongoing chromosomal instability, but this is restricted to predominantly diploid tumours (WGD-low). By contrast, predominantly WGD tumours (WGD-high), despite increased missegregation, exhibited cell-cycle dysregulation, STING1 repression, and immunosuppressive phenotypic states. Together, these findings establish WGD as an ongoing mutational process that promotes evolvability and dysregulated immunity in high-grade serous ovarian cancer.