Genetic and non-genetic clonal diversity in cancer evolution

Nat Rev Cancer. 2021 Jun;21(6):379-392. doi: 10.1038/s41568-021-00336-2. Epub 2021 Mar 16.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Clonal Evolution*
  • Disease Progression
  • Genetic Heterogeneity*
  • Genome, Human*
  • Humans
  • Neoplasms / etiology
  • Neoplasms / pathology*
  • Transcriptome*
  • Tumor Microenvironment / immunology*