Prediction of tumour growth and prognosis

PCT/GB2024/052831The clonal history of a cell is recorded within its (epi)genome via the accumulation of heritable changes. Studying the patterns of theses eritable changes allows for the reconstruction of a tissue's clonal architecture and the dynamics of clone replacements. However, existing markers, such as the accumulation of single nucleotide variants (SNVs), occur infrequently ant therefore are only suitable for recording clonal dynamics that occur over long timescales.Embodiments of the present invention described herein relate to methods of predicting the risk of progression of a cancer of a subject.A method of predicting the risk of progression of a cancer of a subject is described. The method can be used to infer the historical growth dynamics of an individua'ls cancer using fluctuating methylation clocks (FMCs). In case of, for example, chronic lymphocytic leukaemia (CLL) (at least), the inferred growth rate holds valuable prognostic information, enabling patient stratification beyond that of standard clinical practice.