Intratumor heterogeneity in human glioblastoma reflects cancer evolutionary dynamics
Open accessAbstract
Glioblastoma (GB) is the most common and aggressive primary brain malignancy, with poor prognosis and a lack of effective therapeutic options. Accumulating evidence suggests that intratumor heterogeneity likely is the key to understanding treatment failure. However, the extent of intratumor heterogeneity as a result of tumor evolution is still poorly understood. To address this, we developed a unique surgical multisampling scheme to collect spatially distinct tumor fragments from 11 GB patients. We present an integrated genomic analysis that uncovers extensive intratumor heterogeneity, with most patients displaying different GB subtypes within the same tumor. Moreover, we reconstructed the phylogeny of the fragments for each patient, identifying copy number alterations in EGFR and CDKN2A/B/p14ARF as early events, and aberrations in PDGFRA and PTEN as later events during cancer progression. We also characterized the clonal organization of each tumor fragment at the single-molecule level, detecting multiple coexisting cell lineages. Our results reveal the genome-wide architecture of intratumor variability in GB across multiple spatial scales and patient-specific patterns of cancer evolution, with consequences for treatment design.
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Glioblastoma is the most common malignant primary brain tumor, but it is classified as a rare disease because its incidence rate of 3 per 100,000 people is below the rare disease definition rate of less than 10 per 100,000 people.
“While glioblastoma is the most common malignant primary brain tumor26–28, it is still classified as a “rare” disease, as its incidence rate (i.e., 3/100,000 people) is substantially lower than the rare disease definition rate (i.e., <10/100,000 people)24.”
From Federated learning enables big data for rare cancer boundary detection (2022) · cites this paper as [28]
GBM is challenged by molecular heterogeneity and genetic instability, even within the same patient.
“A significant challenge in the development of efficacious treatments for GBM is the molecular heterogeneity and genetic instability of these tumors, even within the same patient.38”
From Combination therapy in a xenograft model of glioblastoma: Enhancement of the antitumor activity of temozolomide by an MDM2 antagonist (2017) · cites this paper as [38]
Most clinically relevant solid tumors are highly heterogeneous at the phenotypic, physiologic, and genomic levels and continue to evolve over time.
“It is now appreciated that most clinically relevant solid tumors are highly heterogeneous at the phenotypic, physiologic, and genomic levels (13–15) and that they continue to evolve over time.”
From Radiomics: Images Are More than Pictures, They Are Data (2016) · cites this paper as [15]
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- Authors
- Sottoriva, A., Spiteri, I., Piccirillo, S. G. M., Touloumis, A., Collins, V. P., Marioni, J. C., Curtis, C., Watts, C., & Tavaré, S.
- Affiliations
- University of Southern California (US)
- Cancer Research UK (GB)
- University of Cambridge (GB)
- European Bioinformatics Institute (GB)
- ORCID
- Venue
- Proceedings of the National Academy of Sciences
- Publisher
- National Academy of Sciences
- Published
- 2013-02-14
- Volume
- 110
- Issue
- 10
- Pages
- 4009-4014
- ISSN
- 0027-8424 (ISSN-L)
- 1091-6490
- PMC
- PMC3593922
- OpenAlex
- W2040458067
- Cited by
- 1,737
- References
- 43
- Citations by year
- 2026: 68 · 2025: 82 · 2024: 107 · 2023: 140 · 2022: 134 · 2021: 171 · 2020: 170 · 2019: 154 · 2018: 153 · 2017: 153 · 2016: 137 · 2015: 126 · 2014: 107 · 2013: 32 · 2012: 1
- FWCI
- 47.09
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Proceedings of the National Academy of Sciences (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- University of Brighton Repository (University of Brighton) (submittedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
- Funders
- Cancer Research UK (19556, C14303/A10825)
- Brain Tumour Charity (10/136)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer Genomics and Diagnostics
- Health Sciences › Medicine › Genetics › Glioma Diagnosis and Treatment
- Health Sciences › Medicine › Hematology › Acute Myeloid Leukemia Research
- Keywords
- glioblastoma, intratumoral heterogeneity, tumor evolution, phylogenetic inference, copy number alterations, EGFR, PDGFRA, PTEN, clonal architecture, single-molecule sequencing, tumor subtypes, tumor progression
- MeSH terms
- Base Sequence, Brain Neoplasms, Chromosome Aberrations, DNA, Neoplasm, Glioblastoma, Humans, Phylogeny, Disease Progression, Genes, erbB-1, Evolution, Molecular, Genes, p16, DNA Copy Number Variations, Transcriptome
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