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Tumor heterogeneity:
different clones may drive different metastatic
sites
Govindan, Science 2014
nt clones and
rough gradual
t are also sec-
ic events (such
arrangement),
neity in a tu-
f next-genera-
hese processes
the initiation, maintenance, and progression
of lung cancer to improve these outcomes.
The complex genomic landscape of
NSCLC related to tobacco smoking is char-
acterized by innumerable single-nucleotide
variations, gene amplifications, insertions,
deletions, and structural rearrangements
(
12
,
13
). By contrast, there are strikingly
Lung
tumor
Brain
metastasis
Bone
metastasis
Liver metastasis
Normal
cell
Founding
clone
Lung tumor
at diagnosis
Tumor after
treatment
Tumor at
relapse
Lung cancer resilience.
Amodel is shown of how a tumor may
acquire progressively fitter clones, giving rise to subclonal populations
and tumor heterogeneity.
Clonal heterogeneity
over time
Spatial heterogeneity at given timepoint