Biological and Therapeutic Impact of Intratumor Heterogeneity in Cancer Evolution

被引：853

作者：

McGranahan, Nicholas ^{[1
,2
]}

Swanton, Charles ^{[1
,3
]}

机构：

[1] Canc Res UK London Res Inst, London WC2A 3LY, England

[2] UCL, Ctr Math & Phys Life Sci & Expt Biol CoMPLEX, London WC1E 6BT, England

[3] UCL Canc Inst, London WC1E 6DD, England

来源：

CANCER CELL | 2015年 / 27卷 / 01期

基金：

欧洲研究理事会;

关键词：

CELL LUNG-CANCER; ACUTE MYELOID-LEUKEMIA; CHRONIC LYMPHOCYTIC-LEUKEMIA; 21 BREAST CANCERS; CHROMOSOMAL INSTABILITY; ACQUIRED-RESISTANCE; CLONAL EVOLUTION; GENETIC-HETEROGENEITY; MUTATIONAL PROCESSES; GENOMIC INSTABILITY;

D O I：

10.1016/j.ccell.2014.12.001

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Precision medicine requires an understanding of cancer genes and mutational processes, as well as an appreciation of the extent to which these are found heterogeneously in cancer cells during tumor evolution. Here, we explore the processes shaping the cancer genome, placing these within the context of tumor evolution and their impact on intratumor heterogeneity and drug development. We review evidence for constraints and contingencies to tumor evolution and highlight the clinical implications of diversity within tumors. We outline the limitations of genome-driven targeted therapies and explore future strategies, including immune and adaptive approaches, to address this therapeutic challenge.

引用

页码：15 / 26

页数：12

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