A narrative review of tumor heterogeneity and challenges to tumor drug therapy

Abstract

Objective: To accurately evaluate tumor heterogeneity, make multidimensional diagnosis according to the causes and phenotypes of tumor heterogeneity, and assist in the individualized treatment of tumors.Background: Tumor heterogeneity is one of the most essential characteristics of malignant tumors. In tumor recurrence, development, and evolution, tumor heterogeneity can lead to the formation of different cell groups with other molecular characteristics. Tumor heterogeneity can be characterized by the uneven distribution of tumor cell subsets of other genes between and within the disease site (spatial heterogeneity) or the time change of cancer cell molecular composition (temporal heterogeneity). The discovery of tumor targeting drugs has dramatically promoted tumor therapy. However, the existence of heterogeneity seriously affects the effect of tumor treatment and the prognosis of patients. Methods:The literature discussing tumor heterogeneity and its resistance to tumor therapy was broadly searched to analyze tumor heterogeneity as well as the challenges and solutions for gene detection and tumor drug therapy. Conclusions:Tumor heterogeneity is affected by many factors consist of internal cell factors and cell microenvironment. Tumor heterogeneity greatly hinders effective and individualized tumor treatment.Understanding the fickle of tumors in multiple dimensions and flexibly using a variety of detection methods to capture the changes of tumors can help to improve the design of diagnosis and treatment plans for cancer and benefit millions of patients.

Assessment of spatial transcriptomics for oncology discovery

“…Our study leverages a small clinical cohort, which is sufficient to assess technology but limited in its broader applications to better understand PDAC heterogeneity. 107 , 108 , 109 It is well established that tumors display spatial heterogeneity, with the “necrotic core” serving as a hallmark example wherein core regions of solid tumors have foci of cell death relative to the tumor periphery. 68 , 110 However, it is challenging to probe depth correlates in clinical tumor samples because tumors are divided for FFPE preservation, and center-to-edge architecture is not preserved.…”

New classification for advanced breast cancer patients experiencing disease progression during salvage treatment: a single-center retrospective cohort study

“…Despite the breakthrough of antineoplastic medication, no effective and specific treatment for heterogeneous tumors has yet been applied (7). The rapid development of inter-tumor heterogeneity causes difficulty in clinical tumor treatment (28,29). It is vital to measure the tumor heterogeneity in clinical practice.…”

Lunasin as a Promising Plant-Derived Peptide for Cancer Therapy

“…Genetic, epigenetic, and phenotypic changes cause inter- and intratumoral heterogeneity; when this dynamic variation occurs in a single tumor, temporal heterogeneity is also observed [ 80 ]. Cancer heterogeneity can lead to drug resistance, limiting treatment effectiveness, and combining therapies has been applied to address this problem [ 80 , 81 , 82 ]. Therapeutic agents with multiple types of anticancer activity are therefore promising candidates for improving therapeutic effectiveness.…”