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Despite showing vast genetic diversity, the authors were able to elucidate a distinct pattern of genomic instability [ 79].
The specific targeting of a distinct pattern of genomic instability is the subject of investigation in the phase II trial CINATRA discussed in this paper.
Known molecular features characteristic for BRCA1-mutated breast tumors are 1) a high degree of genomic instability due to homologous recombination (HR) deficiency [ 18], 2) a distinct pattern of genomic aberrations [ 19- 22] 3) a high frequency of TP53 mutations and 4) a high incidence of complex, protein-truncating TP53 mutations [ 10, 23].
There are several known molecular features characteristic for BRCA1-mutated breast tumors: 1) increased numbers of genomic aberrations, 2) a distinct pattern of genomic aberrations, 3) a high frequency of TP53 mutations and 4) a high incidence of complex, protein-truncating TP53 mutations.
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Their key idea is that the expression of haploinsufficient genes must be precisely regulated during normal development, and such regulation can be manifested in distinct patterns of genomic regulatory elements.
11, 12 Gastrointestinal adenocarcinomas of the esophagus, stomach, and colon exhibit distinct patterns of genomic instability and oncogenesis.
Lastly, distinct patterns of genomic γ-H2AX enrichment (DSBs) identified in this study suggest disparate mechanisms of DSB formation in UNG-competent and -deficient cells.
Recent evidence has suggested that this heterogeneity is underpinned by distinct patterns of genomic aberrations, which may contribute to the different transcriptomic profiles and clinical phenotypes [ 1- 4].
These two subgroups, referred to as the BRCA1- and BRCA2-related subgroups respectively, displayed distinct patterns of genomic alterations and high instability indices.
Evidence suggests that CIN may be an exploitable phenotype and that cytotoxic compounds exist that may have preferential activity in cells with distinct patterns of genomic instability (Roschke and Kirsch, 2005).
There is now good pre-clinical evidence to suggest that distinct patterns of genomic instability, as opposed to defined aberrations in signalling pathways discussed later, may affect the therapeutic response.
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