2017_SBRT_Course Book

How cancers evolve?

• Cancer cells constantly accrue a variety of genetic alterations • Subclones arising from founder clones show heterogeneity in their genetic makeup • Cancer cells are exposed to a variety of selection pressures induced by decreased blood supply, hypoxia, and treatment-related effects • Resulting selection and expansion of subclones with genetic makeup that is ideal for continued survival

Devarakonda S, Ann Oncol 2017