Illustration of chromosomes from a cancer cell showing large-scale alterations.

Charles Swanton : TRAcking Cancer Evolution through therapy/Rx (TRACERx) clinical study

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Our group has initiated the TRACERx Lung and Renal cancer clinical studies that aim to decipher tumour evolutionary trajectories in early non-small cell lung cancer and renal cancer (Figure 1).

Through multi-region sequencing analysis of primary tumours and recurrent metastatic biopsies we will attempt to address the origins of the lethal tumour subclone, distinguish the changing patterns of tumour evolution over time, the associations of intratumour heterogeneity with disease outcome and the host immune response, and the impact of cancer cytotoxics upon the emergent subclonal genetic landscape at relapse. The studies will also work with the CRUK funded PEACE program which allows for the consent of patients at the end of life for post-mortem analysis of multiple metastatic sites so that high resolution evolutionary histories can be deciphered.

Our work is revealing the diversity of tumour evolutionary processes that foster cell to cell variation, mechanisms of immune evasion as well as deterministic aspects to disease progression and metastases.

Overview of TRACERx

Figure 1. Overview of TRACERx (Tracking Lung Cancer Evolution through Therapy/Rx).