Hsieh James J, Cheng Emily H
Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.
Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, 10065, USA.
Clin Transl Med. 2016 Dec;5(1):42. doi: 10.1186/s40169-016-0123-4. Epub 2016 Oct 20.
With the ever-increasing complexity of tumor heterogeneity (TH) discovered through cancer genome sequencing, it is apparent that TH has become the biggest hurdle for precision cancer therapeutics. Through studying the genomics of exceptional responders to targeted therapeutic agents in kidney cancer, we demonstrated parallel convergent gene/pathway/capability/function evolution of kidney cancer in the context of TH, which prompted us to propose a new cancer evolution model "the braided cancer river model". Based on this model, we might be able to outsmart a given cancer type within an individual patient through simultaneously inhibiting preferred parallel pathways or sequential nodes. Thus, the goals of this perspective are to define tumor heterogeneity, discuss tumor evolution, introduce braided cancer river model, and improve precision medicine.
随着通过癌症基因组测序发现的肿瘤异质性（TH）日益复杂，显然TH已成为精准癌症治疗的最大障碍。通过研究肾癌中对靶向治疗药物有特殊反应者的基因组学，我们证明了在TH背景下肾癌的平行趋同基因/通路/能力/功能进化，这促使我们提出一种新的癌症进化模型——“辫状癌河模型”。基于此模型，我们或许能够通过同时抑制优先的平行通路或连续节点，在个体患者体内战胜特定类型的癌症。因此，本观点的目标是定义肿瘤异质性、讨论肿瘤进化、介绍辫状癌河模型并改善精准医学。
