Genome of cancer cells has been mapped out by the researchers from upwards of 50 tumors among patients with Wilms tumours, rhabdomyosarcoma, and neuroblastoma. Mutations were tracked that led to emergence of four main survival strategies, which were namely chaos, coexistence, tolerance, and competition, all four strategies can occur within a single tumor simultaneously.
Strategies of chaos or competition present in tumours at onset of illness have a risk of relapse of over 50%. Tolerance and coexistence strategy variants typically have good patient outcomes. Some cancer cells are programmed from outset to create a relapse. First tumours should not be set as proxy to predict targeted treatments in case of relapse, new biopsy are well warranted.
Researchers hope to conduct further studies to identify which mechanisms drive survival strategies that cancer cells adopt in first stage of disease. If more was known regarding environments that trigger cancer cell development it would be possible to influence how cells change during treatment and help to prevent relapse. Funding is currently being applied for by the team for a major study to investigate whether the four strategies can be used in the clinic.