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  • Review Article
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Understanding and overcoming tumor heterogeneity in metastatic breast cancer treatment

Nature Cancer volume 2, pages 680–692 (2021)Cite this article

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Abstract

Rational development of targeted therapies has revolutionized metastatic breast cancer outcomes, although resistance to treatment remains a major challenge. Advances in molecular profiling and imaging technologies have provided evidence for the impact of clonal diversity in cancer treatment resistance, through the outgrowth of resistant clones. In this Review, we focus on the genomic processes that drive tumoral heterogeneity and the mechanisms of resistance underlying metastatic breast cancer treatment and discuss implications for future treatment strategies.

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Fig. 1: Illustrative representation of the clonal evolution of BC.
Fig. 2: Models of tumor evolution.
Fig. 3: Gompertzian tumor growth curves.
Fig. 4: Effects of targeted therapy and treatment schedules on ITH.

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Authors and Affiliations

  1. Breast Cancer Now Toby Robins Breast Cancer Research Centre, The Institute of Cancer Research, London, UK

    Nida Pasha & Nicholas C. Turner

  2. Ralph Lauren Centre for Breast Cancer Research and Breast Unit, Royal Marsden Hospital, London, UK

    Nicholas C. Turner

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  1. Nida Pasha
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N.C.T. has received advisory board honoraria from AstraZeneca, Bristol-Myers Squibb, Lilly, Merck, Sharpe and Dohme, Novartis, Pfizer, Roche/Genentech, GlaxoSmithKline, Zentalis pharmaceuticals, Repare Therapeutics and Arvinas and research funding from AstraZeneca, BioRad, Pfizer, Roche/Genentech, Merck, Sharpe and Dohme, and Guardant Health.

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Pasha, N., Turner, N.C. Understanding and overcoming tumor heterogeneity in metastatic breast cancer treatment. Nat Cancer 2, 680–692 (2021). https://doi.org/10.1038/s43018-021-00229-1

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