1. Diagnostic approaches to measure the impact of cancer therapies on clonal evolution.
Diagnostic approaches to measure the impact of cancer therapies on clonal evolution. Tumors are molecularly heterogeneous. Multiregion biopsies provide a snapshot of this heterogeneity, allowing the reconstruction of a tumor phylogenetic tree and the identification of ubiquitous, shared, or private alterations. Liquid biopsy allows, through ctDNA analysis, real-time monitoring of changes in tumor heterogeneity under the selective pressure of anticancer treatments. Analysis of the allelic frequencies of subclonal alterations provides a measure of growth dynamics of the different cell populations within a tumor, whereas quantification of trunk alterations allows normalization for tumor burden. Circulating tumor cells could integrate biological information obtained by ctDNA sequencing, and circulating immune cells could help describe the evolution of the tumor-responsive immune microenvironment.
Nabil Amirouchene-Angelozzi et al. Cancer Discov 2017;7:
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