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Deprecated: Implicit conversion from float 245.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Evol+Med+Public+Health 2015 ; 2015 (1): 76-87 Nephropedia Template TP
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Divergent and convergent evolution in metastases suggest treatment strategies based on specific metastatic sites #MMPMID25794501
Cunningham JJ; Brown JS; Vincent TL; Gatenby RA
Evol Med Public Health 2015[]; 2015 (1): 76-87 PMID25794501show ga
Cancer cells, although maximally fit at their primary site, typically have lower fitness on the adaptive landscapes offered by the metastatic sites due to organ-specific variations in mesenchymal properties and signaling pathways. Clinically evident metastases will exhibit time-dependent divergence from the phenotypic mean of the primary population as the tumor cells evolve and adapt to their new circumstances. In contrast, tumors from different primary sites evolving on identical metastatic adaptive landscapes exhibit phenotypic convergence so that, for example, metastases in the liver from different primary tumors will evolve toward similar adaptive phenotypes. The combination of evolutionary divergence from the primary cancer phenotype and convergence towards similar adaptive strategies in the same tissue cause significant variations in treatment responses particularly for highly targeted therapies.This suggest that optimal therapies for disseminated cancer must take into account the site(s) of metastatic growth as well as the primary organ.