title: Intratumor heterogeneity: seeing the wood for the trees.
abstract: Most advanced solid tumors remain incurable, with resistance to chemotherapeutics and targeted therapies a common cause of poor clinical outcome. Intratumor heterogeneity may contribute to this failure by initiating phenotypic diversity enabling drug resistance to emerge and by introducing tumor sampling bias. Envisaging tumor growth as a Darwinian tree with the trunk representing ubiquitous mutations and the branches representing heterogeneous mutations may help in drug discovery and the development of predictive biomarkers of drug response.
authors.affiliation: Department of Medicine, Royal Marsden NHS Foundation Trust, Sutton, Surrey, UK.
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Yap
authors.forename: Marco
authors.initials: M
authors.lastname: Gerlinger
authors.forename: P Andrew
authors.initials: PA
authors.lastname: Futreal
authors.forename: Lajos
authors.initials: L
authors.lastname: Pusztai
authors.forename: Charles
authors.initials: C
authors.lastname: Swanton
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism; D019008:Drug Resistance, Neoplasm / Q000235:genetics; D018740:Genetic Heterogeneity; D023281:Genomics; D006801:Humans; D008957:Models, Genetic; D009154:Mutation / Q000235:genetics; D009369:Neoplasms / Q000235:genetics* / Q000473:pathology
chemical_list: D014408:Biomarkers, Tumor