Q (haiku): What is the most common cancer type in the MSK-CHORD Study based on sample count?

▶ read_guide
{
 "uri": "cbioportal://faq-guide"
}

▶ list_studies
{
 "search": "MSK-CHORD"
}

◀ result
# cBioPortal FAQ Guide

Curated answers to frequently asked general questions about cBioPortal. Source: [cBioPortal FAQ](https://docs.cbioportal.org/user-guide/faq/).

## What is cBioPortal?

cBioPortal for Cancer Genomics is an open-access, open-source resource for interactive exploration of multidimensional cancer genomics data sets. It was originally developed at Memorial Sloan Kettering Cancer Center (MSK) and is now maintained by a multi-institutional team.

## History

- **2008**: cBioPortal first became available online.
- **2012**: First major publication — Cerami et al., *Cancer Discovery*.
- **2013**: Second major publication — Gao et al., *Science Signaling*.
- **2023**: Third major publication — de Bruijn et al., *Cancer Research*.

## How to Cite cBioPortal

When using cBioPortal in publications, cite these three papers:

1. Cerami et al. "The cBio Cancer Genomics Portal: An Open Platform for Exploring Multidimensional Cancer Genomics Data." *Cancer Discovery* 2, 401–404 (2012). doi:10.1158/2159-8290.CD-12-0095
2. Gao et al. "Integrative Analysis of Complex Cancer Genomics and Clinical Profiles Using the cBioPortal." *Science Signaling* 6, pl1 (2013). doi:10.1126/scisignal.2004088
3. de Bruijn et al. "Analysis and Visualization of Longitudinal Genomic and Clinical Data from the AACR Project GENIE Biopharma Collaborative in cBioPortal." *Cancer Research* 83, 3861–3867 (2023). doi:10.1158/0008-5472.CAN-23-0816

Also cite the specific study publication(s) whose data you used.

## What Data Types Does cBioPortal Contain?

- **Mutations** (non-synonymous somatic mutations)
- **DNA copy-number alterations** (CNA) from GISTIC or other methods
- **mRNA expression** data (RNA-seq, microarray)
- **Protein/phosphoprotein** levels (RPPA, mass spectrometry)
- **DNA methylation** data
- **Structural variants** (gene fusions, rearrangements)
- **Clinical data** (demographics, diagnosis, treatment, outcomes)

Note: Synonymous mutations are not included in cBioPortal.

## Data Types Usually Not Stored Directly

cBioPortal generally does not store:

- raw CT, MRI, pathology-slide, or histology image files
- raw sequencing files such as BAM, CRAM, or FASTQ
- polygenic risk scores as a standard data type
- full external clinical-trial databases

However, this deployment may contain links to external viewers or portals through `resource_*` tables. For imaging, pathology, Minerva, HTAN, or viewer questions, read `cbioportal://external-resources-guide` and check those tables before saying the data is absent.

## What the MCP Agent Can and Cannot Produce

The MCP agent can:

- query cBioPortal data and return tables in text/JSON/Markdown
- summarize counts, frequencies, and available attributes
- provide cBioPortal study links and DataHub download links when applicable
- provide SQL snippets or handoff instructions for R/Python/cBioPortal tools

The MCP agent should not promise to:

- render Kaplan-Meier plots or other visual figures directly
- export large … (6558 more chars)

◀ result
{"result":[{"cancer_study_identifier":"msk_chord_2024","name":"MSK-CHORD (MSK, Nature 2024)","type_of_cancer_id":"mixed","sample_count":25040,"has_guide":true,"url":"https://www.cbioportal.org/study/summary?id=msk_chord_2024"}]}

▶ get_study_guide
{
 "study_id": "msk_chord_2024"
}

◀ result
# MSK-CHORD (MSK, Nature 2024)

**Study ID:** `msk_chord_2024`

## Overview
Targeted sequencing via MSK-IMPACT panels. Clinical annotations include some derived from natural language processing (denoted NLP).

**Exactly five cancer types** (`CANCER_TYPE`, patients): Non-Small Cell Lung Cancer 7,809, Colorectal Cancer 5,543, Breast Cancer 5,368, Prostate Cancer 3,211, Pancreatic Cancer 3,109. There is **no melanoma** or any other cancer type; say so up front if asked, instead of substituting another type.

**No therapy-response variable.** There is no RECIST, objective response, or best-response attribute or event. For treatment-outcome questions (e.g. immunotherapy response), say this first; the only proxies are `OS_MONTHS`/`OS_STATUS`, or NLP radiology progression events (`Diagnosis` events with `SUBTYPE = 'Progression'`, key `PROGRESSION` = Y/N/Indeterminate), in patients with `Treatment` events of the relevant `SUBTYPE` (e.g. `Immuno`: 3,341 patients). Hand off the comparison to cBioPortal group comparison / survival.

**Nearly one sample per patient: 24,950 patients / 25,040 samples.** Only 90 patients have more than one sample, and all 90 have samples from two different cancer types (second primaries); only 26 have both a `Primary` and a `Metastasis` sample. There is no meaningful same-patient (paired) primary-vs-metastasis cohort. For "same patient" / paired questions, say this up front, then offer the **unpaired** comparison of all `Primary` vs `Metastasis` samples (`SAMPLE_TYPE`), labelled as unpaired.
```sql
SELECT countIf(n > 1) AS multi_sample_patients,         -- 90
       countIf(has_p AND has_m) AS primary_and_met      -- 26
FROM (SELECT patient_unique_id, count() AS n,
             has(groupArray(attribute_value), 'Primary') AS has_p,
             has(groupArray(attribute_value), 'Metastasis') AS has_m
      FROM clinical_data_derived
      WHERE cancer_study_identifier = 'msk_chord_2024' AND attribute_name = 'SAMPLE_TYPE'
      GROUP BY patient_unique_id);
```

## Gene Panels
This study uses multiple MSK-IMPACT panel versions:
- **IMPACT341**: Earlier version, 341 genes
- **IMPACT410**: 410 genes
- **IMPACT468**: 468 genes  
- **IMPACT505**: Latest version, 505 genes

**Important:** Different samples may have different gene coverage. Always use gene-specific denominators when calculating mutation frequencies.

## Clinical Attributes - Semantic Guide

### Cancer Classification
| Attribute | Description | Values |
|-----------|-------------|--------|
| `CANCER_TYPE` | Broad cancer category | e.g., "Non-Small Cell Lung Cancer", "Breast Cancer" |
| `CANCER_TYPE_DETAILED` | Specific subtype | e.g., "Lung Adenocarcinoma", "Invasive Ductal Carcinoma" |
| `ONCOTREE_CODE` | OncoTree classification code | Standardized cancer type codes |

### Sample Information
| Attribute | Description | Values |
|-----------|-------------|--------|
| `SAMPLE_TYPE` | Sample origin | Primary, Metastasis, Local Recurrence, Unknown |
| `SAMPLE_CLASS` | Sample … (5439 more chars)

▶ clickhouse_run_select_query
{
 "query": "
SELECT 
    attribute_value AS cancer_type,
    COUNT(DISTINCT sample_unique_id) AS sample_count
FROM clinical_data_derived
WHERE cancer_study_identifier = 'msk_chord_2024'
  AND attribute_name = 'CANCER_TYPE'
GROUP BY attribute_value
ORDER BY sample_count DESC
",
 "max_rows": 100
}

◀ result
{"rows":[{"cancer_type":"Non-Small Cell Lung Cancer","sample_count":7809},{"cancer_type":"Colorectal Cancer","sample_count":5543},{"cancer_type":"Breast Cancer","sample_count":5368},{"cancer_type":"Prostate Cancer","sample_count":3211},{"cancer_type":"Pancreatic Cancer","sample_count":3109}]}

═ answer (success)
## Most Common Cancer Type in MSK-CHORD

**Non-Small Cell Lung Cancer** is the most common cancer type in the MSK-CHORD study, representing **7,809 samples** (31.2% of the 25,040 total samples).

### Cancer Type Distribution (by sample count):

| Cancer Type | Sample Count | Percentage |
|---|---|---|
| **Non-Small Cell Lung Cancer** | **7,809** | **31.2%** |
| Colorectal Cancer | 5,543 | 22.1% |
| Breast Cancer | 5,368 | 21.4% |
| Prostate Cancer | 3,211 | 12.8% |
| Pancreatic Cancer | 3,109 | 12.4% |

The MSK-CHORD study comprises exactly these five cancer types, with lung adenocarcinoma and colorectal cancer together accounting for over half of all samples.

[View MSK-CHORD Study](https://www.cbioportal.org/study/summary?id=msk_chord_2024)