Intratumoral genetic heterogeneity of driver somatic mutations is present in a variety of tumor types, yet the extent of heterogeneity is variable. We propose that this variation is a reflection of the inherent biology of a given tumor type, representing the pace of metastatic dissemination and hence clinical disease course.
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References
Greaves, M. Cancer Discov. 5, 806–820 (2015).
Greaves, M. Nat. Rev. Cancer 7, 213–221 (2007).
Gillies, R. J., Verduzco, D. & Gatenby, R. A. Nat. Rev. Cancer 12, 487–493 (2012).
Williams, M. J. et al. Nat. Genet. 50, 895–903 (2018).
Greaves, M. & Maley, C. C. Nature 481, 306–313 (2012).
Turajlic, S. et al. Cell 173, 595–610 (2018).
Makohon-Moore, A. P. et al. Nat. Genet. 49, 358–366 (2017).
Maley, C. C. et al. Nat. Rev. Cancer 17, 605–619 (2017).
Krabbe, L.-M., Bagrodia, A., Margulis, V. & Wood, C. Semin. Intervent. Radiol. 31, 27–32 (2014).
Kleeff, J. et al. Nat. Rev. Dis. Primers 2, 16022 (2016).
Winter, J. M. et al. Ann. Surg. Oncol. 19, 169–175 (2012).
Turajlic, S. et al. Cell 173, 581–594 (2018).
McDonald, O. G. O. G. et al. Nat. Genet. 49, 367–376 (2017).
Gomez, K. et al. BMC Cancer 18, 85 (2018).
Gundem, G. et al. Nature 520, 353–357 (2015).
Kohutek, Z. A. et al. Cold Spring Harb. Mol. Case Stud. 3, a001701 (2017).
Blakely, C. M. et al. Nat. Genet. 49, 1693–1704 (2017).
Juric, D. et al. Nature 518, 240–244 (2015).
Jamal-Hanjani, M. et al. N. Engl. J. Med. 376, 2109–2121 (2017).
Kovac, M. et al. Nat. Commun. 6, 6336 (2015).
Acknowledgements
Research support by CA179991 and CA220508 to C.A.I.D., who also receives research support from Bristol-Myers Squibb. K.L. is supported by a UK Medical Research Council Skills Development Fellowship Award (grant reference number MR/P014712/1). C.S. is supported by the Francis Crick Institute that receives its core funding from Cancer Research UK (FC001169,FC001202), the UK Medical Research Council (FC001169, FC001202), and the Wellcome Trust (FC001169, FC001202) and from Cancer Research UK (TRACERx, PEACE and CRUK Cancer Immunotherapy Catalyst Network), the CRUK Lung Cancer Centre of Excellence, Stand Up 2 Cancer (SU2C), the Rosetrees Trust, NovoNordisk Foundation (ID16584) and the Breast Cancer Research Foundation (BCRF), European Research Council under the European Union’s Seventh Framework Programme (FP7/2007-2013)/ ERC grant agreement n°FP7 – 617844 (PROTEUS) and Marie Curie Network PloidyNet.
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Iacobuzio-Donahue, C.A., Litchfield, K. & Swanton, C. Intratumor heterogeneity reflects clinical disease course. Nat Cancer 1, 3–6 (2020). https://doi.org/10.1038/s43018-019-0002-1
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DOI: https://doi.org/10.1038/s43018-019-0002-1
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