How many molecular subtypes? Implications of the unique tumor principle in personalized medicine - PubMed
Review
How many molecular subtypes? Implications of the unique tumor principle in personalized medicine
Shuji Ogino et al. Expert Rev Mol Diagn. 2012 Jul.
Abstract
Cancers are complex multifactorial diseases. For centuries, conventional organ-based classification system (i.e., breast cancer, lung cancer, colon cancer, colorectal cancer, prostate cancer, lymphoma, leukemia, and so on) has been utilized. Recently, molecular diagnostics has become an essential component in clinical decision-making. However, tumor evolution and behavior cannot accurately be predicted, despite numerous research studies reporting promising tumor biomarkers. To advance molecular diagnostics, a better understanding of intratumor and intertumor heterogeneity is essential. Tumor cells interact with the extracellular matrix and host non-neoplastic cells in the tumor microenvironment, which is influenced by genomic variation, hormones, and dietary, lifestyle and environmental exposures, implicated by molecular pathological epidemiology. Essentially, each tumor possesses its own unique characteristics in terms of molecular make-up, tumor microenvironment and interactomes within and between neoplastic and host cells. Starting from the unique tumor concept and paradigm, we can better classify tumors by molecular methods, and move closer toward personalized cancer medicine and prevention.
Conflict of interest statement
Financial & competing interests disclosure
The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.
No writing assistance was utilized in the production of this manuscript.
Figures

To simplify, only several examples of such factors are shown, and no interaction between the factors is depicted. In addition, there is probably a chance factor in the process of carcinogenesis.

Each tumor pathway is unique, but we can classify similar tumor pathways into one type or one subtype. See explanation in the section titled ‘How many tumor subtypes?’
Similar articles
-
Proteome Heterogeneity in Colorectal Cancer.
Lim LC, Lim YM. Lim LC, et al. Proteomics. 2018 Feb;18(3-4). doi: 10.1002/pmic.201700169. Epub 2018 Jan 25. Proteomics. 2018. PMID: 29316255 Review.
-
Breast cancer intratumor genetic heterogeneity: causes and implications.
Ng CK, Pemberton HN, Reis-Filho JS. Ng CK, et al. Expert Rev Anticancer Ther. 2012 Aug;12(8):1021-32. doi: 10.1586/era.12.85. Expert Rev Anticancer Ther. 2012. PMID: 23030222 Review.
-
Molecular pathological epidemiology gives clues to paradoxical findings.
Nishihara R, VanderWeele TJ, Shibuya K, Mittleman MA, Wang M, Field AE, Giovannucci E, Lochhead P, Ogino S. Nishihara R, et al. Eur J Epidemiol. 2015 Oct;30(10):1129-35. doi: 10.1007/s10654-015-0088-4. Epub 2015 Oct 7. Eur J Epidemiol. 2015. PMID: 26445996 Free PMC article.
-
Cancer classification in the genomic era: five contemporary problems.
Song Q, Merajver SD, Li JZ. Song Q, et al. Hum Genomics. 2015 Oct 19;9:27. doi: 10.1186/s40246-015-0049-8. Hum Genomics. 2015. PMID: 26481255 Free PMC article. Review.
-
Leveraging Single-Cell Approaches in Cancer Precision Medicine.
Nath A, Bild AH. Nath A, et al. Trends Cancer. 2021 Apr;7(4):359-372. doi: 10.1016/j.trecan.2021.01.007. Epub 2021 Feb 6. Trends Cancer. 2021. PMID: 33563578 Free PMC article. Review.
Cited by
-
Hamada T, Nowak JA, Milner DA Jr, Song M, Ogino S. Hamada T, et al. J Pathol. 2019 Apr;247(5):615-628. doi: 10.1002/path.5236. Epub 2019 Feb 20. J Pathol. 2019. PMID: 30632609 Free PMC article. Review.
-
Guo F, Gong H, Zhao H, Chen J, Zhang Y, Zhang L, Shi X, Zhang A, Jin H, Zhang J, He Y. Guo F, et al. Sci Rep. 2018 Apr 17;8(1):6076. doi: 10.1038/s41598-018-24306-1. Sci Rep. 2018. PMID: 29666387 Free PMC article.
-
Accounting for tumor purity improves cancer subtype classification from DNA methylation data.
Zhang W, Feng H, Wu H, Zheng X. Zhang W, et al. Bioinformatics. 2017 Sep 1;33(17):2651-2657. doi: 10.1093/bioinformatics/btx303. Bioinformatics. 2017. PMID: 28472248 Free PMC article.
-
Prospective study of family history and colorectal cancer risk by tumor LINE-1 methylation level.
Ogino S, Nishihara R, Lochhead P, Imamura Y, Kuchiba A, Morikawa T, Yamauchi M, Liao X, Qian ZR, Sun R, Sato K, Kirkner GJ, Wang M, Spiegelman D, Meyerhardt JA, Schernhammer ES, Chan AT, Giovannucci E, Fuchs CS. Ogino S, et al. J Natl Cancer Inst. 2013 Jan 16;105(2):130-40. doi: 10.1093/jnci/djs482. Epub 2012 Nov 21. J Natl Cancer Inst. 2013. PMID: 23175808 Free PMC article.
-
Wang S, Wang S, Wang Z. Wang S, et al. Front Med (Lausanne). 2023 Jan 10;9:1109365. doi: 10.3389/fmed.2022.1109365. eCollection 2022. Front Med (Lausanne). 2023. PMID: 36703893 Free PMC article. Review.
References
-
- Baudhuin LM, Donato LJ, Uphoff TS. How novel molecular diagnostic technologies and biomarkers are revolutionizing genetic testing and patient care. Expert Rev. Mol. Diagn. 2012;12(1):25–37. - PubMed
-
- Roukos DH. Novel clinico–genome network modeling for revolutionizing genotype–phenotype-based personalized cancer care. Expert Rev. Mol. Diagn. 2010;10(1):33–48. - PubMed
-
- Metodiev MV. Biomarkers research in Europe: focus on personalized medicine. Expert Rev. Mol. Diagn. 2011;11(7):689–690. - PubMed
-
- Hamilton SR. Targeted therapy of cancer: new roles for pathologists in colorectal cancer. Mod. Pathol. 2008;21(Suppl. 2):S23–S30. - PubMed
-
- Gulley ML, Braziel RM, Halling KC, et al. Clinical laboratory reports in molecular pathology. Arch. Pathol. Lab. Med. 2007;131(6):852–863. - PubMed
Publication types
MeSH terms
Grants and funding
LinkOut - more resources
Full Text Sources
Other Literature Sources