Cancer Reviews 2021 series: Cancer evolution: Darwin and beyond

Clinical and laboratory studies over recent decades have established branched evolution as a feature of cancer. However, while grounded in somatic selection, several lines of evidence suggest a Darwinian model alone is insufficient to fully explain cancer evolution. First, the role of macroevolutionary events in tumour initiation and progression contradicts Darwin''s central thesis of gradualism. Whole‐genome doubling, chromosomal chromoplexy and chromothripsis represent examples of single catastrophic events which can drive tumour evolution. Second, neutral evolution can play a role in some tumours, indicating that selection is not always driving evolution. Third, increasing appreciation of the role of the ageing soma has led to recent generalised theories of age‐dependent carcinogenesis. Here, we review these concepts and others, which collectively argue for a model of cancer evolution which extends beyond Darwin. We also highlight clinical opportunities which can be grasped through targeting cancer vulnerabilities arising from non‐Darwinian patterns of evolution.     

肿瘤研究的金钥匙:肿瘤干细胞

“肿瘤干细胞学说”认为肿瘤组织不是均一的,其中只有一小部分肿瘤干细胞具有诱发并维持肿瘤恶性表达的能力。这一概念的提出为肿瘤真正意义上的靶向治疗找到了良方妙药,即选择性杀伤肿瘤干细胞从而治愈肿瘤。找到肿瘤干细胞并了解其生物学特性对我们真正理解肿瘤的发生、发展和转归机制,根治肿瘤并防止肿瘤的转移和复发具有积极意义。本文概述对人淋巴细胞白血病、乳腺肿瘤、脑部肿瘤及其他肿瘤的肿瘤干细胞及其相关机制的研究进展。