Collateral Lethality: A New Therapeutic Strategy in Oncology

Genomic deletion of tumor suppressor genes (TSGs) is a rite of passage for virtually all human cancers. The synthetic lethal paradigm has provided a framework for the development of molecular targeted therapeutics that are functionally linked to the loss of specific TSG functions. In the course of genomic events that delete TSGs, a large number of genes with no apparent direct role in tumor promotion also sustain deletion as a result of chromosomal proximity to the target TSG. In this perspective, we review the novel concept of 'collateral lethality', which has served to identify cancer-specific therapeutic vulnerabilities resulting from codeletion of passenger genes neighboring TSGs. The large number of collaterally deleted genes, playing diverse functions in cell homeostasis, offers a rich repertoire of pharmacologically targetable vulnerabilities presenting novel opportunities for the development of personalized antineoplastic therapies.