Genetic insights into the morass of metastatic heterogeneity.

Genetic insights into the morass of metastatic heterogeneity.
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DOI:
10.1038/nrc.2017.126
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发表时间:
2018-04
期刊:
Nature reviews. Cancer
影响因子:
--
通讯作者:
Wakefield L
Wakefield L
中科院分区:
其他
文献类型:
--
作者:
Hunter KW;Amin R;Deasy S;Ha NH;Wakefield L

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肿瘤的异质性给癌症的临床治疗带来了很大的问题。癌症基因组的体细胞进化导致原发肿瘤中遗传上不同的亚克隆,具有不同的生物学特性和治疗敏感性。由于转移过程的复杂性和肿瘤细胞必须克服的多个生物学障碍,在转移性疾病中异质性的问题更加复杂。测序技术和临床样本获取的新进展在体细胞肿瘤遗传学水平上为转移和原发肿瘤的系统发生关系提供了洞察力,同时也阐明了转移过程的基本机制。除了肿瘤细胞在身体上获得的遗传异质性外,遗传的基于群体的遗传异质性可以深刻地改变转移生物学,并进一步使有效的、广泛适用的抗转移治疗的发展复杂化。在这里,我们研究遗传异质性如何影响转移性疾病,以及当前知识对未来研究努力和治疗干预的影响。
Tumour heterogeneity poses a substantial problem for the clinical management of cancer. Somatic evolution of the cancer genome results in genetically distinct subclones in the primary tumour with different biological properties and therapeutic sensitivities. The problem of heterogeneity is compounded in metastatic disease owing to the complexity of the metastatic process and the multiple biological hurdles that the tumour cell must overcome to establish a clinically overt metastatic lesion. New advances in sequencing technology and clinical sample acquisition are providing insights into the phylogenetic relationship of metastases and primary tumours at the level of somatic tumour genetics while also illuminating fundamental mechanisms of the metastatic process. In addition to somatically acquired genetic heterogeneity in the tumour cells, inherited population-based genetic heterogeneity can profoundly modify metastatic biology and further complicate the development of effective, broadly applicable antimetastatic therapies. Here, we examine how genetic heterogeneity impacts metastatic disease and the implications of current knowledge for future research endeavours and therapeutic interventions.
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