Tumor Heterogeneity Confounds and Illuminates: Assessing the implications

Certain biological features are inherent traits of cancer, yet some of them still hold mysteries for researchers and clinicians. The heterogeneity of a tumor mass is an old concept that has lately become both a puzzling factor and a feature that should be harnessed to better understand tumor vulnerabilities. Improved scientific approaches to further determine and uncover the meaning of these heterogeneous features are still needed to translate findings into ways to develop therapies, identify drug response biomarkers and stratify patients. In Bedside to Bench, Maria Kleppe and Ross L. Levine look at recent clinical cancer trials that have advanced the field and discuss main questions regarding the role of tumor heterogeneity in predicting therapeutic response and tumor progression. In addition, they raise awareness of the relevance of the interactions among different tumor entities and their contribution to the malignancy of the whole tumor. In Bench to Bedside, Kornelia Polyak peruses studies that uncover specific mutations conferring endocrine drug resistance in breast tumors and that add to our knowledge of the evolution and architecture of tumors, and she discusses how this can be used to implement drug regimens.

Access options

Rent or Buy article

Get time limited or full article access on ReadCube.

from$8.99

All prices are NET prices.

Figure 1: Biological and clinical consequences of tumor heterogeneity.

Katie Vicari

References

  1. 1

    Vogelstein, B. et al. Science 339, 1546–1558 (2013).

  2. 2

    Ciriello, G. et al. Nat. Genet. 45, 1127–1133 (2013).

  3. 3

    Fearon, E.R. & Vogelstein, B. Cell 61, 759–767 (1990).

  4. 4

    Patel, J.P. et al. N. Engl. J. Med. 366, 1079–1089 (2012).

  5. 5

    Lawrence, M.S. et al. Nature 499, 214–218 (2013).

  6. 6

    Ding, L. et al. Nature 481, 506–510 (2012).

  7. 7

    Walter, M.J. et al. N. Engl. J. Med. 366, 1090–1098 (2012).

  8. 8

    Gerlinger, M. et al. N. Engl. J. Med. 366, 883–892 (2012).

  9. 9

    Magrangeas, F. et al. Leukemia 27, 473–481 (2013).

  10. 10

    Landau, D.A. et al. Cell 152, 714–726 (2013).

  11. 11

    Clappier, E. et al. J. Exp. Med. 208, 653–661 (2011).

  12. 12

    Notta, F. et al. Nature 469, 362–367 (2011).

  13. 13

    Papaemmanuil, E. et al. Blood 122, 3616–3627 (2013).

  14. 14

    Lohr, J.G. et al. Cancer Cell 25, 91–101 (2014).

Download references

Author information

Correspondence to Ross L Levine.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Kleppe, M., Levine, R. Tumor Heterogeneity Confounds and Illuminates: Assessing the implications. Nat Med 20, 342–344 (2014). https://doi.org/10.1038/nm.3522

Download citation

Further reading