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Charting intratumor heterogeneity from bench to bedside
Jonathan C M Wan1,2,3,4, Nicholas McGranahan5,6, Charles Swanton7,8,9
1Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK.
Nature Cancer
|August 7, 2026
Summary
Intratumor heterogeneity, the diversity within tumors, complicates cancer diagnosis and treatment. Understanding tumor evolution is key to developing better cancer diagnostics and therapies.
Area of Science:
- Oncology and Cancer Biology
- Genomics and Molecular Biology
Background:
- Intratumor heterogeneity presents a significant obstacle in cancer care, impacting diagnosis, treatment response, and metastasis.
- Tumor ecosystems exhibit dynamic evolution driven by genetic and non-genetic factors within cancer cells and their microenvironment.
Purpose of the Study:
- To synthesize current knowledge on tumor heterogeneity and evolution.
- To explore how understanding tumor evolution can guide the development of novel diagnostic and therapeutic strategies.
Main Methods:
- Review of multiregion and multiomic tissue profiling studies.
- Analysis of functional studies and longitudinal plasma sampling data.
- Synthesis of current research on cancer cell and microenvironment complexity.
Main Results:
- Tumor evolution is a multidimensional process involving complex genetic and non-genetic mechanisms.
- Insights into tumor evolution are crucial for advancing cancer care.
- The dynamic nature of tumors necessitates evolution-aware approaches.
Conclusions:
- A comprehensive understanding of intratumor heterogeneity and evolution is essential for improving cancer patient outcomes.
- Developing evolution-aware diagnostic and therapeutic strategies holds significant promise for overcoming treatment resistance and metastasis.
