It is argued that tumour evolution is not a binary state, but a dynamic continuum shaped by genetic and non-genetic heterogeneity, spatial constraints, microenvironmental pressures and therapeutic bottlenecks, which will align these models with therapeutic decision-making in precision oncology.
Abstract
Current methods for distinguishing neutral from selection-driven tumour evolution rely on assumptions frequently violated in clinical samples. We argue that tumour evolution is not a binary state, but a dynamic continuum shaped by genetic and non-genetic heterogeneity, spatial constraints, microenvironmental pressures and therapeutic bottlenecks. Refining evolutionary inference through integrative, longitudinal and spatially resolved analyses will be essential to align these models with therapeutic decision-making in precision oncology.
This review synthesizes current knowledge on clonal dynamics, intratumor heterogeneity (ITH), and the mathematical tools used to model cancer progression, with direct implications for the design of precision oncology strategies.
Wei Li, Xiao-Tong Wang· Infection, Genetics and Evol...· 0 citations
It is argued that population genetics provides the mathematical framework needed to extract evolutionary dynamics from cancer genomes and it is shown how models of mutation, selection and drift transform allele frequencies from descriptive measurements into quantitative estimates of clonal fitness and evolutionary timi...
G. Caravagna, Trevor A. Graham, A. Sottoriva· Nature Reviews. Cancer· 1 citation
It is proposed that tumor indolence is an actively maintained condition of restrained malignant potential, sustained by a multilayer restraint architecture encompassing lineage and epigenetic barriers, epithelial cell competition, immune containment, stromal organization, and vascular and metabolic limitations.
Xin-Pu Tang, Tian-Jian Lu, Mengyao Wang et al.· Cell Reports· 0 citations
Rapid in vivo zebrafish assays can help to resolve variant pathogenicity within weeks, providing organism-level evidence that informs treatment decisions, prevents unnecessary interventions, and strengthens precision medicine.
The current understanding of heterogeneity and evolution is synthesized and it is discussed how these insights can inform the development of evolution-aware diagnostic and therapeutic strategies.
J. Wan, N. Mcgranahan, C. Swanton· Nature Cancer· 0 citations
The Holistic Integrative Tumor Ecosystem Theory (HITET) is proposed, a five-dimensional framework connecting these scales through functional interfaces that synthesizes how genetic alterations, cellular plasticity, metabolic programs, immune and stromal interactions, spatial gradients, organ-specific environments, micr...
Yong-Lin He, Liang Niu, Yan-Ming Ren et al.· Signal Transduction and Targ...· 0 citations
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