Genetic and non-genetic clonal diversity in cancer evolution.
James R M BlackNicholas McGranahanPublished in: Nature reviews. Cancer (2021)
The observation and analysis of intra-tumour heterogeneity (ITH), particularly in genomic studies, has advanced our understanding of the evolutionary forces that shape cancer growth and development. However, only a subset of the variation observed in a single tumour will have an impact on cancer evolution, highlighting the need to distinguish between functional and non-functional ITH. Emerging studies highlight a role for the cancer epigenome, transcriptome and immune microenvironment in functional ITH. Here, we consider the importance of both genetic and non-genetic ITH and their role in tumour evolution, and present the rationale for a broad research focus beyond the cancer genome. Systems-biology analytical approaches will be necessary to outline the scale and importance of functional ITH. By allowing a deeper understanding of tumour evolution this will, in time, encourage development of novel therapies and improve outcomes for patients.
Keyphrases
- papillary thyroid
- genome wide
- squamous cell
- copy number
- dna methylation
- stem cells
- gene expression
- clinical trial
- lymph node metastasis
- type diabetes
- ejection fraction
- single cell
- childhood cancer
- prognostic factors
- mass spectrometry
- skeletal muscle
- metabolic syndrome
- young adults
- rna seq
- patient reported outcomes
- patient reported