Abstract
Paraphrasing Dobzhansky’s famous dictum, I discuss how interrogating cancer through the lens of evolution has transformed our understanding of its development, causality and treatment resistance. The emerging picture of cancer captures its extensive diversity and therapeutic resilience, highlighting the need for more innovative approaches to control.
Highlights
Paraphrasing Dobzhansky’s famous dictum, I discuss how interrogating cancer through the lens of evolution has transformed our understanding of its development, causality and treatment resistance
An appreciation that cancer clones develop, or evolve, in the context of a complex tissue ecosystem has transformed our understanding of cancer biology and highlighted the need for more innovative approaches to therapy that can thwart evolutionary resilience [7,8,9]
An evolutionary logic pervades all major areas of cancer sciences including causation, cancer clone development and resistance to therapies [10] (Fig. 1)
Summary
Portrait of cancer cell diversity and its variegated genetics [24] has considerable practical implications for patient prognosis, monitoring and treatment [8,9,10]. It is likely that self-renewing, or stem, cells are the major cellular substrate for the selective processes that underlie clonal architecture, progression of disease, metastasis, recurrence and drug resistance As such, they provide both the evolutionary units of selection [42,43,44] in cancer and the ultimate targets for therapeutic control or cure [10, 38, 45, 46]. One explanation for at least some of the very high risk of cancer in humans that this author favours is that it reflects the impact of chronic exposure to an evolutionary mismatch [6, 53]: a mismatch between our rapid social evolution and ‘modern’ lifestyles versus historical, evolutionary adaptations (Fig. 4). Reduced microbial exposures in infancy may underlie the increased risk of childhood acute lymphoblastic leukaemia in affluent, developed societies as they deprive the immune system of the ‘educational’ microbial exposure required for its network settings [63]
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