Implications of intratumour heterogeneity for treatment stratification

Despite advances in the diagnosis and treatment of cancer, the majority of advanced metastatic solid tumours remain incurable. Differential gene expression, somatic mutational status, tumour‐specific genetic signatures and micro‐environmental selection pressures within individual tumours have implic...

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Bibliographic Details
Published in:The Journal of pathology 2014-01, Vol.232 (2), p.264-273
Main Authors: Crockford, Andrew, Jamal-Hanjani, Mariam, Hicks, James, Swanton, Charles
Format: Article
Language:English
Subjects:
Animals
Antineoplastic Agents - therapeutic use
Biomarkers, Tumor - genetics
Gene Expression Regulation, Neoplastic
Genetic Predisposition to Disease
Genetic Testing
Genomics - methods
Humans
intratumour heterogeneity
Molecular Targeted Therapy
Neoplasms - drug therapy
Neoplasms - genetics
Neoplasms - metabolism
Neoplasms - pathology
Patient Selection
patient-derived xenograft models
personalized medicine
Phenotype
Precision Medicine
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Summary:Despite advances in the diagnosis and treatment of cancer, the majority of advanced metastatic solid tumours remain incurable. Differential gene expression, somatic mutational status, tumour‐specific genetic signatures and micro‐environmental selection pressures within individual tumours have implications for the success of predictive assays to guide therapeutic intervention. In this review we discuss the evidence for genetic and phenotypic heterogeneity and its potential implications for clinical decision making. We highlight areas of research that could be improved in order to better stratify patient treatment. We also discuss the predictive potential of patient‐derived models of tumour response, including xenograft and cell line‐based systems within the context of intratumour heterogeneity. Copyright © 2013 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.
ISSN:0022-3417
1096-9896
DOI:10.1002/path.4270