RT Journal Article SR Electronic T1 Functional linkage of gene fusions to cancer cell fitness assessed by pharmacological and CRISPR/Cas9 screening JF bioRxiv FD Cold Spring Harbor Laboratory SP 559690 DO 10.1101/559690 A1 Gabriele Picco A1 Elisabeth D Chen A1 Luz Garcia Alonso A1 Fiona M Behan A1 Emanuel Gonçalves A1 Graham Bignell A1 Angela Matchan A1 Beiyuan Fu A1 Ruby Banerjee A1 Elizabeth Anderson A1 Adam Butler A1 Cyril H Benes A1 Ultan McDermott A1 David Dow A1 Francesco Iorio A1 Euan Stronach A1 Fengtang Yang A1 Kosuke Yusa A1 Julio Saez-Rodriguez A1 Mathew J Garnett YR 2019 UL http://biorxiv.org/content/early/2019/02/24/559690.abstract AB Many gene fusions have been reported in tumours and for most their role remains unknown. As fusions can be used clinically for diagnostic and prognostic purposes, and are targets for treatment, it is crucial to assess their functional implications in cancer. To investigate the role of fusions in tumor cell fitness, we developed a systematic analysis utilising RNA-sequencing data from 1,011 human cancer cell lines to functionally link 8,354 gene fusion events with genomic data, sensitivity to >350 anti-cancer drugs and CRISPR-Cas9 loss-of-fitness information. Established clinically-relevant fusions were readily identified. Overall, functional fusions were rare, including those involving cancer driver genes, suggesting that many fusions are dispensable for tumor cell fitness. Novel therapeutically actionable fusions involving RAF1, BRD4 and ROS1 were verified in new histologies. In addition, recurrent YAP1-MAML2 fusions were identified as activators of Hippo-pathway signaling in multiple cancer types, supporting therapeutic targeting of Hippo signalling. Our approach discriminates functional fusions, identifying new drivers of carcinogenesis and fusions that could have important clinical implications.Significance We identify fusions as new potential candidates for drug repurposing and drivers of carcinogenesis. These results support histology agnostic marker-driven precision cancer medicine. Most fusions are not functional with implications for interpreting cancer fusions reported from clinical sequencing studies.