Untangling the web of intratumour heterogeneity

Intratumour heterogeneity (ITH) is a hallmark of cancer that drives tumour evolution and disease progression. Technological and computational advances have enabled us to assess ITH at unprecedented depths, yet this accumulating knowledge has not had a substantial clinical impact. This is in part due to a limited understanding of the functional relevance of ITH and the inadequacy of preclinical experimental models to reproduce it. Here, we discuss progress made in these areas and illuminate future directions. In this Review, Polyak and colleagues discuss cellular and microenvironmental mechanisms that contribute to intratumour heterogeneity and how this affects immune escape and tumour progression.

Automated summary

This article discusses the causes of intratumour heterogeneity (ITH) and its impact on immune escape and tumour progression. Although advances in technology and computational methods have allowed us to assess ITH more effectively, our understanding of the functional relevance of ITH remains limited.