A collection of nine papers (https://www.nature.com/collections/haffgaicaf) published in 2020 and 2019 in various Nature journals and presented as a single “TRACERx” collection online on May 27, 2020 in a special section of Nature has transformed our understanding of how lung cancer evolves over time, in particular how the surrounding environment and immune system drives changes. The collective findings from the pioneering TRACERx (Tracking Cancer Evolution Through Therapy) study (http://www.cruklungcentre.org/Research/TRACERx) have already changed the way researchers and clinicians view lung cancer, leading to new clinical trials and research projects aimed at tackling these hard-to-treat tumors. The process of cancer evolution closely mirrors the way that species evolve through natural selection. As lung cancer cells multiply, mutations take place in their DNA, which can help, harm, or have no effect. A helpful mutation may make the cell resistant to certain treatments or able to more quickly digest the nutrients it needs to divide. But observing the product of this evolution only provides part of the picture. For example, in order to understand the variety of different finches on the Galapagos Islands, Charles Darwin needed to consider the different environments in which each of the finches lived. The same is true for studying cancer evolution. One needs to understand the surrounding environment, i.e., the body, to understand why and how a tumor is going to evolve. This complex challenge is being tackled by the TRACERx consortium, led by researchers at the Francis Crick Institute and the University College London (UCL), and funded by Cancer Research UK. Findings from the first 100 patients studied have now been brought together in this special Nature collection.
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