Abstract
Despite extraordinary efforts to profile cancer genomes on a large scale, interpreting the vast amount of genomic data in the light of cancer evolution and in a clinically relevant manner remains challenging. Here we demonstrate that cancer next-generation sequencing data is dominated by the signature of growth governed by a power-law distribution of mutant allele frequencies. The power-law signature is common to multiple tumor types and is a consequence of the effectively-neutral evolutionary dynamics that underpin the evolution of a large proportion of cancers, giving rise to the abundance of mutations responsible for intra-tumor heterogeneity. Importantly, the law allows the measurement, in each individual cancer, of the in vivo mutation rate and the timing of mutations with remarkable precision. This result provides a new way to interpret cancer genomic data by considering the physics of tumor growth in a way that is both patient-specific and clinically relevant.