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Study reveals cancer’s ‘infinite’ ability to evolve

Posted on the 25th April 2023

Cancer Cells Evolve

An unprecedented analysis of how cancers grow has revealed the "almost infinite" ability of tumors to evolve and survive.

The TracerX study is the most in-depth analysis of how cancers evolve and what causes them to spread.

The results of tracking lung cancers for nine years left the research team "surprised" and "in awe" at the formidable force they were up against. Scientists have concluded that there is a pressing need to focus on cancer prevention, as a universal cure is unlikely any time soon.

Cancers change and evolve over time - they are not immutable. They can become more aggressive, better at evading the immune system, and able to spread around the body.

A tumor starts as a single, corrupted cell, but becomes a mixture of millions of cells that have all mutated in slightly different ways.

TracerX tracked that diversity and how it changes over time inside lung cancer patients and say the results would apply across different types of cancer.

More than 400 people - treated at 13 hospitals in the UK - had biopsies taken from different parts of their lung cancer as the disease progressed.

The evolutionary analysis has been published across seven separate studies in the journals Nature and Nature Medicine.

The research showed:

  • Highly aggressive cells in the initial tumour are the ones that ultimately end up spreading around the body
  • Tumors showing higher levels of genetic "chaos" were more likely to relapse after surgery to other parts of the body
  • Analysing blood for fragments of tumor DNA meant signs of it returning could be spotted up to 200 days before appearing on a CT scan
  • The cellular machinery that reads the instructions in our DNA can become corrupted in cancerous cells making them more aggressive

The researchers hope the findings could, in the future, help them predict how a patient's tumor will spread and tailor treatment accordingly.

Speaking about the findings, Professor Charles Swanton, from the Francis Crick Institute and University College London, said he was surprised at how adaptable tumors are.

“I don't want to sound too depressing about this, but I think - given the almost infinite possibilities in which a tumour can evolve, and the very large number of cells in a late-stage tumour, which could be several hundred billion cells - then achieving cures in all patients with late-stage disease is a formidable task.

“I don't think we're going to be able to come up with universal cures.

“If we want to make the biggest impact we need to focus on prevention, early detection and early detection of relapse.”

Related: UK cancer cases to increase by a third by 2040

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