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Implications of intratumour heterogeneity for treatment stratification
Author(s) -
Crockford Andrew,
JamalHanjani Mariam,
Hicks James,
Swanton Charles
Publication year - 2014
Publication title -
the journal of pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.964
H-Index - 184
eISSN - 1096-9896
pISSN - 0022-3417
DOI - 10.1002/path.4270
Subject(s) - context (archaeology) , genetic heterogeneity , pathological , risk stratification , oncology , selection (genetic algorithm) , medicine , phenotype , somatic cell , bioinformatics , computational biology , biology , gene , genetics , computer science , machine learning , paleontology
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.