Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA.
Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA; Department of Medicine, Harvard Medical School, Boston, MA, USA.
Trends Cancer. 2023 Sep;9(9):726-737. doi: 10.1016/j.trecan.2023.05.001. Epub 2023 May 27.
Intratumor heterogeneity (ITH) is a driver of tumor evolution and a main cause of therapeutic resistance. Despite its importance, measures of ITH are still not incorporated into clinical practice. Consequently, standard treatment is frequently ineffective for patients with heterogeneous tumors as changes to treatment regimens are made only after recurrence and disease progression. More effective combination therapies require a mechanistic understanding of ITH and ways to assess it in clinical samples. The growth of technologies enabling the spatially intact analysis of tumors at the single-cell level and the development of sophisticated preclinical models give us hope that ITH will not simply be used as a predictor of a poor outcome but will guide treatment decisions from diagnosis through treatment.
肿瘤内异质性（ITH）是肿瘤进化的驱动因素，也是治疗耐药的主要原因。尽管其重要性不言而喻，但 ITH 的测量方法仍未纳入临床实践。因此，对于异质性肿瘤患者，标准治疗通常效果不佳，因为只有在复发和疾病进展后才会改变治疗方案。更有效的联合治疗需要深入了解 ITH 的机制，并找到在临床样本中评估 ITH 的方法。使肿瘤单细胞水平空间完整分析成为可能的技术的发展以及复杂的临床前模型的开发，使我们有希望不仅将 ITH 用作不良预后的预测指标，而且还可以从诊断到治疗全程指导治疗决策。
