Abstract:
The classification of tumors into subtypes, characterized by phenotypes determined by specific differentiation pathways, aids diagnosis and directs therapy towards targeted approaches. However, with the advent and explosion of next-generation sequencing, cancer phenotypes are turning out to be far more heterogenous than initially thought, and the classification is continually being updated to include more subtypes. Tumors are indeed highly dynamic, and they can evolve and undergo various changes in their characteristics during disease progression. The picture becomes even more complex when the tumor responds to a therapy. In all these cases, cancer cells acquire the ability to transdifferentiate, changing subtype, and adapt to changing microenvironments. These modifications affect the tumor\'s growth rate, invasiveness, response to treatment, and overall clinical behavior. Studying tumor subtype transitions is crucial for understanding tumor evolution, predicting disease outcomes, and developing personalized treatment strategies. We discuss this emerging hallmark of cancer and the molecular mechanisms involved at the crossroads between tumor cells and their microenvironment, focusing on four different human cancers in which tissue plasticity causes a subtype switch: breast cancer, prostate cancer, glioblastoma, and pancreatic adenocarcinoma.
摘要:
肿瘤的亚型分类,以特定分化途径决定的表型为特征,有助于诊断,并将治疗引向有针对性的方法。然而,随着下一代测序的出现和爆发,癌症表型比最初想象的要异质得多,并且分类不断更新以包括更多的子类型。肿瘤确实是高度动态的,它们可以在疾病进展过程中进化并经历各种特征变化。当肿瘤对治疗有反应时,情况变得更加复杂。在所有这些情况下,癌细胞获得转分化的能力,改变子类型,适应不断变化的微环境。这些改变会影响肿瘤的生长速度,侵入性,对治疗的反应,和整体临床行为。研究肿瘤亚型转变对于理解肿瘤演变至关重要。预测疾病结果,制定个性化治疗策略。我们讨论了癌症的这一新兴标志以及肿瘤细胞与其微环境之间的十字路口所涉及的分子机制。关注四种不同的人类癌症,其中组织可塑性导致亚型转换:乳腺癌,前列腺癌,胶质母细胞瘤,和胰腺腺癌。