Intratumoral heterogeneity in cancer progression and response to immunotherapy

Most (if not all) tumors emerge and progress under a strong evolutionary pressure imposed by trophic, metabolic, immunological, and therapeutic factors. The relative impact of these factors on tumor evolution changes over space and time, ultimately favoring the establishment of a neoplastic microenv...

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Bibliographic Details
Published inNature medicine Vol. 27; no. 2; pp. 212 - 224
Main Authors Vitale, Ilio, Shema, Efrat, Loi, Sherene, Galluzzi, Lorenzo
Format Journal Article
LanguageEnglish
Published United States Nature Publishing Group 01.02.2021
Subjects
Care and treatment
Development and progression
Disease Progression
Drug Resistance, Neoplasm - genetics
Genetic aspects
Genetic Heterogeneity
Heterogeneity
Humans
Immunologic Factors - genetics
Immunology
Immunotherapy
Medical treatment
Microenvironments
Neoplasms - genetics
Neoplasms - immunology
Neoplasms - pathology
Patient outcomes
Tumor Microenvironment - genetics
Tumor Microenvironment - immunology
Tumors
Italy
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Summary:Most (if not all) tumors emerge and progress under a strong evolutionary pressure imposed by trophic, metabolic, immunological, and therapeutic factors. The relative impact of these factors on tumor evolution changes over space and time, ultimately favoring the establishment of a neoplastic microenvironment that exhibits considerable genetic, phenotypic, and behavioral heterogeneity in all its components. Here, we discuss the main sources of intratumoral heterogeneity and its impact on the natural history of the disease, including sensitivity to treatment, as we delineate potential strategies to target such a detrimental feature of aggressive malignancies.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
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ObjectType-Review-1
ISSN:1078-8956
1546-170X
DOI:10.1038/s41591-021-01233-9