Normal tissue architecture determines the evolutionary course of cancer

Cancer growth can be described as a caricature of the renewal process of the tissue of origin, where the tissue architecture has a strong influence on the evolutionary dynamics within the tumor. Using a classic, well-studied model of tumor evolution (a passenger-driver mutation model) we systematically alter spatial constraints and cell mixing rates to show how tissue structure influences functional (driver) mutations and genetic heterogeneity over time. This approach explores a key mechanism behind both inter-patient and intratumoral tumor heterogeneity: competition for space. Time-varying competition leads to an emergent transition from Darwinian premalignant growth to subsequent invasive neutral tumor growth. Initial spatial constraints determine the emergent mode of evolution (Darwinian to neutral) without a change in cell-specific mutation rate or fitness effects. Driver acquisition during the Darwinian precancerous stage may be modulated en route to neutral evolution by the combination of two factors: spatial constraints and limited cellular mixing. These two factors occur naturally in ductal carcinomas, where the branching topology of the ductal network dictates spatial constraints and mixing rates. Some cancers occur in spatially constrained tissues such as the mammary gland, and how the morphological features influence the evolution of the cancer is unclear. Here, the authors use mathematical modeling to study the question of competition for space and provide inferences on the mode of evolution of cancers in such tissues.

Automated summary

This study utilized mathematical modeling to investigate the competition for space in cancer evolution in spatially constrained tissues, revealing the significant impact of spatial constraints on tumor evolution. It explored how genetic heterogeneity and driver mutations within tumors change over time, highlighting the role of tissue structure in influencing the mode of cancer evolution.