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A braided cancer river connects tumor heterogeneity and precision medicine

James J Hsieh1, Emily H Cheng2,3

  • 1Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA. hsiehj@mskcc.org.

Clinical and Translational Medicine
|October 22, 2016
PubMed

Insights

Tumor heterogeneity (TH) complicates cancer treatment. Studying kidney cancer revealed parallel evolutionary paths, leading to the "braided cancer river model" to improve precision medicine.

Area of Science:

  • Oncology
  • Genomics
  • Cancer Evolution

Background:

  • Tumor heterogeneity (TH) presents a significant challenge for effective precision cancer therapeutics.
  • Advances in cancer genome sequencing highlight the increasing complexity of TH.

Purpose of the Study:

  • To define tumor heterogeneity and discuss cancer evolution.
  • To introduce the novel
  • braided cancer river model
  • for understanding cancer progression.
  • To propose strategies for improving precision medicine.

Main Methods:

  • Genomic analysis of exceptional responders to targeted therapies in kidney cancer.
  • Investigating parallel convergent evolution of genes, pathways, and functions within the context of TH.

Main Results:

  • Demonstrated parallel convergent gene, pathway, capability, and function evolution in kidney cancer.
  • Identified TH as a major obstacle in developing targeted cancer therapies.

Conclusions:

  • The proposed
  • braided cancer river model
  • offers a new framework for understanding cancer evolution.
  • Simultaneously inhibiting parallel pathways or sequential nodes may outsmart cancer within individual patients.
  • This model has the potential to enhance the efficacy of precision medicine.
Keywords:
Braided cancer river modelBranched evolutionKidney cancerMTOR inhibitorsParallel convergent gene/pathway/capability/function evolutionPrecision medicineTumor heterogeneityVEGF inhibitors

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