癌细胞群体通过一个逐步的过程演化，其中涉及组织生态系统背景下最适应的变异体的自然选择，并受治疗的影响进行修改。对患者样本的基因组审查显示了在相似癌症患者之间和个体患者的癌细胞群体内存在着非同寻常的突变特征多样性。这是否意味着高度分化的演化轨迹，还是存在反复和可预测的模式？在不同物种中，主要的进化创新或适应往往被重复或汇集，反映了普遍的选择压力和对最优解的限制。我们认为，这对于进化中的癌细胞尤其适用，特别是与TP53基因相关。TP53的功能丧失变体是癌症中最常见的遗传变化。我们讨论了可能涉及的微环境选择性压力以及这对细胞适应性、可进化性和可能随后产生药物耐药性的深远影响。 © 2023. BioMed Central Ltd. Springer Nature的一部分。

Cancer cell populations evolve by a stepwise process involving natural selection of the fittest variants within a tissue ecosystem context and as modified by therapy. Genomic scrutiny of patient samples reveals an extraordinary diversity of mutational profiles both between patients with similar cancers and within the cancer cell population of individual patients. Does this signify highly divergent evolutionary trajectories or are there repetitive and predictable patterns?Major evolutionary innovations or adaptations in different species are frequently repeated, or convergent, reflecting both common selective pressures and constraints on optimal solutions. We argue this is true of evolving cancer cells, especially with respect to the TP53 gene. Functional loss variants in TP53 are the most common genetic change in cancer. We discuss the likely microenvironmental selective pressures involved and the profound impact this has on cell fitness, evolvability and probability of subsequent drug resistance.© 2023. BioMed Central Ltd., part of Springer Nature.