Among the four mutational signatures (6, 15, 20, and 26) associated with defective DNA mismatch repair [38], two (20 and 6) were found in primary tumours T1 and T3, respectively, consistent with DNA repair gene mutations, namely PRDM9 and TET2 [24,25] in T1, and EP400 and POU2F1 [32,33] in T3, as well as potential genetic predisposition, as described above. Here, POU2F1 is linked to neoplasm.