Results from the first long-term study of how lung cancer evolves has been published in the journals Nature and Nature Medicine, with the researchers hoping the findings could help predict how a patient’s tumour will spread and enable them to tailor treatment.
The Cancer Research UK-funded TRACERx study has been following hundreds of non-small cell lung cancer (NSCLC) patients since 2014, from their point of diagnosis throughout their treatment, to monitor how their tumours changed over time.
While the research was carried out on patients with NSCLC – the most common form of lung cancer – the team say their findings could also be applied to other cancer types, such as skin or kidney cancer.
Across seven studies, the Francis Crick Institute-based researchers found that tumours can be made up of many different populations of cancer cells which carry constantly changing sets of genes, with higher rates of diversity associated with an increased likelihood of cancer returning within one year of treatment.
The team also found that some patterns of DNA changes can provide clues on what a patient’s cancer might do next, and these patterns could indicate to doctors which parts of a tumour might grow and spread to other parts of the body in the future.
With this knowledge, doctors treating lung cancer patients could potentially identify those whose cancer is at risk of returning after surgery or not responding to treatment and allow them to intervene by following up with further treatment.
Professor Charles Swanton, Cancer Research UK’s chief clinician and lead researcher on TRACERx, said: “TRACERx recognises that cancer is not static and the way we treat patients shouldn’t be either. What makes the TRACERx project particularly powerful is that it treats tumours as ever-changing ecosystems made up of diverse cancer cell populations.
“By looking at the tumour in its entirety, we can observe how these cell populations interact and even compete with one another, gleaning valuable insights into how the tumour is likely to evolve over time, spread and respond to treatment.”
TRACERx has already entered its next phase, with the seven-year TRACERx EVO study set to build on its findings.