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Tumor heterogeneity: how could we use it to achieve better clinical outcomes?

  • Arsani Yousef , Lucianna Ghobrial and Eleftherios P. Diamandis ORCID logo EMAIL logo
Published/Copyright: October 12, 2023
Diagnosis
From the journal Diagnosis Volume 11 Issue 1

Abstract

Differences in tumors related to location, tissue type, and histological subtype have been well documented for decades. Tumors are also molecularly very diverse. In this short review we describe the current classification schemes for tumor heterogeneity. We enlist the various drivers of tumor heterogeneity generation and comment on their clinical significance. New molecular techniques promise to assess tumor heterogeneity at affordable cost, so that these techniques can soon enter the clinic. While tumor heterogeneity currently represents a major unfavorable barrier in the field of oncology, it may also be a key in revolutionizing cancer diagnosis and treatment. Information regarding tumor heterogeneity has the potential to provide more thorough prognostic information, guide more efficacious combination treatment regimens, and lead to the development of novel therapeutic strategies and identification of new targets. For these gains to be realized, assessment of tumor heterogeneity needs to be incorporated into current diagnostic protocols but standardized and reproducible assessment methods are required. Fortunately, when these advances are realized, tumor heterogeneity has the potential to improve clinical outcomes.

Keywords: tumor heterogeneity; classification; responses to treatment
Corresponding author: Eleftherios P. Diamandis, MD, PhD, FRCP(C), FRSC, Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, 60 Murray St. Box 32, Floor 6, Rm L6-201, Toronto, ON, M5T 3L9, Canada, Phone: (416) 586 8443, E-mail:

  1. Research ethics: Not applicable.

  2. Informed consent: Not applicable.

  3. Author contributions: The authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  4. Competing interests: Eleftherios Diamandis holds an advisory and consultation role with Abbott Diagnostics. All other authors state no conflict of interest.

  5. Research funding: None declared.

  6. Data availability: Not applicable.

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Received: 2023-08-16
Accepted: 2023-09-17
Published Online: 2023-10-12

© 2023 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. The physical exam and telehealth: between past and future
  4. Review
  5. Features and functions of decision support systems for appropriate diagnostic imaging: a scoping review
  6. Mini Reviews
  7. The PRIDx framework to engage payers in reducing diagnostic errors in healthcare
  8. Tumor heterogeneity: how could we use it to achieve better clinical outcomes?
  9. Original Articles
  10. Factors influencing diagnostic accuracy among intensive care unit clinicians – an observational study
  11. Prevalence of atypical presentations among outpatients and associations with diagnostic error
  12. Preferred language and diagnostic errors in the pediatric emergency department
  13. Diurnal temperature variation and the implications for diagnosis and infectious disease screening: a population-based study
  14. What’s going well: a qualitative analysis of positive patient and family feedback in the context of the diagnostic process
  15. Assessing clinical reasoning skills following a virtual patient dizziness curriculum
  16. Interleukin-6, tumor necrosis factor-α, and high-sensitivity C-reactive protein for optimal immunometabolic profiling of the lifestyle-related cardiorenal risk
  17. Effect of syringe underfilling on the quality of venous blood gas analysis
  18. Short Communications
  19. How do patients and care partners describe diagnostic uncertainty in an emergency department or urgent care setting?
  20. Enhancing clinical reasoning with Chat Generative Pre-trained Transformer: a practical guide
  21. Letters to the Editor
  22. How to overcome hurdles in holding mortality and morbidity conferences on diagnostic error cases in Japan
  23. Medical history-taking by highlighting the time course: PODCAST approach
  24. Journal Reputation Factor
  25. Case Report
  26. Pre-analytical errors in coagulation testing: a case series
  27. Acknowledgement
  28. Acknowledgement
https://doi.org/10.1515/dx-2023-0108
Keywords for this article
tumor heterogeneity; classification; responses to treatment

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. The physical exam and telehealth: between past and future
  4. Review
  5. Features and functions of decision support systems for appropriate diagnostic imaging: a scoping review
  6. Mini Reviews
  7. The PRIDx framework to engage payers in reducing diagnostic errors in healthcare
  8. Tumor heterogeneity: how could we use it to achieve better clinical outcomes?
  9. Original Articles
  10. Factors influencing diagnostic accuracy among intensive care unit clinicians – an observational study
  11. Prevalence of atypical presentations among outpatients and associations with diagnostic error
  12. Preferred language and diagnostic errors in the pediatric emergency department
  13. Diurnal temperature variation and the implications for diagnosis and infectious disease screening: a population-based study
  14. What’s going well: a qualitative analysis of positive patient and family feedback in the context of the diagnostic process
  15. Assessing clinical reasoning skills following a virtual patient dizziness curriculum
  16. Interleukin-6, tumor necrosis factor-α, and high-sensitivity C-reactive protein for optimal immunometabolic profiling of the lifestyle-related cardiorenal risk
  17. Effect of syringe underfilling on the quality of venous blood gas analysis
  18. Short Communications
  19. How do patients and care partners describe diagnostic uncertainty in an emergency department or urgent care setting?
  20. Enhancing clinical reasoning with Chat Generative Pre-trained Transformer: a practical guide
  21. Letters to the Editor
  22. How to overcome hurdles in holding mortality and morbidity conferences on diagnostic error cases in Japan
  23. Medical history-taking by highlighting the time course: PODCAST approach
  24. Journal Reputation Factor
  25. Case Report
  26. Pre-analytical errors in coagulation testing: a case series
  27. Acknowledgement
  28. Acknowledgement
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