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Histologic Transformation in Cancer: The Path for Clinical Translation.

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Cancer cells can change their type to resist treatment, a process called lineage plasticity. This review explores how biopsies and new therapies can help manage this challenge in lung and prostate cancers.

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Area of Science:

  • Oncology
  • Cancer Biology
  • Molecular Pathology

Background:

  • Lineage plasticity, or histologic transformation, is a key cancer progression mechanism allowing tumor cells to evade targeted therapies.
  • This adaptive process, driven by stemness and epigenetic changes, complicates treatment strategies for advanced, therapy-resistant cancers.

Purpose of the Study:

  • To review the diagnostic utility of tissue and liquid biopsies in detecting histologic transformations.
  • To explore emerging therapeutic strategies and clinical challenges in managing treatment-emergent lineage plasticity.
  • To provide a framework for clinical translation and drug development for lineage plasticity.

Main Methods:

  • Review of current evidence on the diagnosis and management of lineage plasticity.
  • Examination of non-small cell lung cancer and prostate cancer models.
  • Discussion of novel molecular targets and therapeutic strategies.

Main Results:

  • Biopsies can detect histologic transformations, aiding in subtype-specific treatment tailoring.
  • Emerging therapies show promise for managing treatment-emergent lineage plasticity.
  • Understanding lineage plasticity is crucial for improving outcomes in advanced cancer.

Conclusions:

  • Lineage plasticity presents significant challenges but offers opportunities for novel therapeutic interventions.
  • Tissue and liquid biopsies are vital tools for diagnosing and managing histologic transformations.
  • Further research and clinical translation are needed to optimize treatment strategies for lineage plasticity.