Personalized Medicine Week 6 Lecture Notes

MOLECULAR EVOLUTION OF CANCER AND CLINICAL TRIALS


What are the necessary and sufficient condition for evolution to occur?
- Variation in the population.
- Variation is heritable.
- Variations can be selected (alter fitness).



The Development of a Cancer is an Evolutionary Process
 Variation in the population (mutation of somatic
cells).
 Variation is heritable (DNA)
 Variations can be selected (clonal expansions).


Evolution Acts on Phenotypes
 DNA mutations can change phenotype.
 Phenotypes are selected by evolution.




Evolutionary Advantage of the Cancer Hallmarks
 Sustained proliferative signalling= more offspring.
 Evading growth suppression= more offspring (less death)
 Avoiding immune destruction= less death
 Enabling replicative immortality= more offspring
 Deregulating cellular energetics= more offspring
 Deregulating cellular energetics= more offspring (less death)
 Resisting cell death= less death
 Enabling characteristics (change the microenvironment)
- Inducing angiogenesis= more resources
- Genome instability= more chance of acquiring other hallmarks