Abstract
The evolutionary forces of mutation and natural selection that are central to cancer development generate heterogeneity within the population of somatic cells that make up a neoplasm. This intra-tumoral heterogeneity can be measured through a variety of means, including cytogenetic analyses to examine chromosomal duplications, losses, and rearrangements; genetic mutations; and epigenetic changes. Studies have established that measures of heterogeneity can have prognostic significance. While heterogeneity is an important property of tumor progression and therapeutic resistance, basic questions about the level of intra-tumoral heterogeneity, the mechanism by which it is established, the dynamics of heterogeneity over time, the optimal method for its measurement, and how these heterogeneity measurements and indices can best be used as universal biomarkers to improve patient care remain unresolved.
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Merlo, L.M.F. (2016). Diversity in Neoplasms. In: Maley, C., Greaves, M. (eds) Frontiers in Cancer Research. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-6460-4_4
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