TUMOUR HETEROGENEITY

摘要

Cancer is not one but many diseases. It is different in each patient and continuously evolves into a progressively complex interplay of diverse tumour cells with their changing environment. In an insightful and prescient 1976 paper, Peter Nowell proposed the now prevailing view of cancer as a process of clonal evolution, in which successive rounds of clonal selection give rise to tumours with diverse genetic and other molecular alterations that may necessitate 'personalized' therapies. Functional and phenotypic heterogeneity of cancer cells has also long been recognized, with experiments as early as the 1930s demonstrating that some but not other cells from mouse tumours could give rise to new tumours when transplanted.