2013
DOI: 10.1146/annurev-pathol-020712-163923
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Cellular Heterogeneity and Molecular Evolution in Cancer

Abstract: Intratumor heterogeneity represents a major obstacle to effective cancer treatment and personalized medicine. However, investigators are now elucidating intratumor heterogeneity at the single-cell level due to improvements in technologies. Better understanding of the composition of tumors, and monitoring changes in cell populations during disease progression and treatment, will improve cancer diagnosis and therapeutic design. Measurements of intratumor heterogeneity may also be used as biomarkers to predict th… Show more

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Cited by 440 publications
(413 citation statements)
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References 150 publications
(170 reference statements)
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“…Intra-tumor heterogeneity, the coexistence of different clones within a tumor, is commonly observed [Greenman et al 2007, Navin et al 2011 and has implications for cancer progression, diagnosis, and treatment [Dexter & Leith 1986, Maley et al 2006, Almendro et al 2013]. Why such heterogeneity exists remains unclear [Merlo et al 2006, Almendro et al 2013, because clones that have a proliferative advantage within the tumour are expected to drive other subclones to extinction.…”
Section: Implications For Cancer Researchmentioning
confidence: 99%
See 1 more Smart Citation
“…Intra-tumor heterogeneity, the coexistence of different clones within a tumor, is commonly observed [Greenman et al 2007, Navin et al 2011 and has implications for cancer progression, diagnosis, and treatment [Dexter & Leith 1986, Maley et al 2006, Almendro et al 2013]. Why such heterogeneity exists remains unclear [Merlo et al 2006, Almendro et al 2013, because clones that have a proliferative advantage within the tumour are expected to drive other subclones to extinction.…”
Section: Implications For Cancer Researchmentioning
confidence: 99%
“…Why such heterogeneity exists remains unclear [Merlo et al 2006, Almendro et al 2013, because clones that have a proliferative advantage within the tumour are expected to drive other subclones to extinction. In the light of evolutionary game theory, however, stable intra-tumor heterogeneity is easily explained as a stable polymorphic equilibrium resulting from the non-linear benefit of growth factors [Archetti et al 2015].…”
Section: Implications For Cancer Researchmentioning
confidence: 99%
“…Tumor cells constantly undergo clonal selection as a result of genetic and epigenetic changes, a process culminating with the presence of distinct subpopulations within the bulk of tumor. 121,122 The clonal composition of a tumor will change depending on the various stages of tumor propagation, hence those mutations that enhance cell division will be selected during the early tumor stage for rapid mass growth, whereas others permitting increased invasiveness and chemoresistance during the later stages. 123 Recent discoveries have shown that RMS tumors seem to be composed of a dominant clone, although each tumor contains subclonal populations with a unique mutational profile, which may provide selective advantage to a relapse or metastatic tumor.…”
Section: Targeting Intratumor Cell Heterogeneity: a Difficult But Promentioning
confidence: 99%
“…The role of the tumor microenvironment including extracellular matrix components and soluble factors in tumor progression [30] and drug resistance [31]has been gradually recognized. Among these factors, abnormal autocrine/paracrine signaling has been associated with breast tumor progression [32].…”
Section: Discussionmentioning
confidence: 99%