Evidence mapPaperPMID 42437748Full record

ReviewSignal transduction and targeted therapy2026

Tumor heterogeneity: development, mechanisms, and therapeutic implications.

Jianhong Zhang, Heng Li, Shuo Ru, Hui Feng, Junsong Guo, Danlei Sun, Tingxiu Xiang, Daqian Xu, Yang Luo

Abstract readReview
In one paragraph

Review in Signal transduction and targeted therapy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Jianhong Zhang *Department of Laboratory Medicine, Chongqing Center for Clinical Laboratory, Chongqing Academy of Medical Sciences, Chongqing General Hospital, School of Medicine, Chongqing University, Chongqing, China.
Heng Li *Department of Laboratory Medicine, Chongqing Center for Clinical Laboratory, Chongqing Academy of Medical Sciences, Chongqing General Hospital, School of Medicine, Chongqing University, Chongqing, China.ORCID http://orcid.org/0000-0002-6666-0277
Shuo Ru *Zhejiang Key Laboratory of Pancreatic Disease, The First Affiliated Hospital, Zhejiang Key Laboratory of Frontier Medical Research on Cancer Metabolism and Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, China.
Hui FengDepartment of Laboratory Medicine, Chongqing Center for Clinical Laboratory, Chongqing Academy of Medical Sciences, Chongqing General Hospital, School of Medicine, Chongqing University, Chongqing, China.
Junsong GuoKey Laboratory for Biorheological Science and Technology of Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, China.
Danlei SunDepartment of Laboratory Medicine, Chongqing Center for Clinical Laboratory, Chongqing Academy of Medical Sciences, Chongqing General Hospital, School of Medicine, Chongqing University, Chongqing, China.
Tingxiu XiangChongqing Key Laboratory for the Mechanism and Intervention of Cancer Metastasis, Chongqing University Cancer Hospital, Chongqing, China. xiangtx@cqmu.edu.cn.
Daqian XuZhejiang Key Laboratory of Pancreatic Disease, The First Affiliated Hospital, Zhejiang Key Laboratory of Frontier Medical Research on Cancer Metabolism and Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, China. xudaqian@zju.edu.cn.
Yang LuoDepartment of Laboratory Medicine, Chongqing Center for Clinical Laboratory, Chongqing Academy of Medical Sciences, Chongqing General Hospital, School of Medicine, Chongqing University, Chongqing, China. luoy@cqu.edu.cn.ORCID http://orcid.org/0000-0002-0166-9027

Funding

China National Funds for Distinguished Young Scientists 82125022National Natural Science Foundation of China (National Science Foundation of China) 82202633National Natural Science Foundation of China (National Science Foundation of China) 82241059Yunnan Provincial Science and Technology Department (Yunnan Department of Science and Technology) 202302AA310039
6 · The paper itself

Abstract

Tumor heterogeneity is a fundamental hallmark of cancer that drives progression, metastasis and therapeutic resistance. This diversity originates from persistent genomic instability, dynamic clonal evolution, and cancer stem cell plasticity, which are further amplified through complex crosstalk within the tumor microenvironment. While conventional therapies effectively eliminate certain tumor cell populations, residual resistant subclones frequently lead to disease relapse. Recent breakthroughs in single-cell multi-omics, spatial transcriptomics, and liquid biopsy now enable a comprehensive, multidimensional dissection of tumor heterogeneity across molecular, cellular, spatial, and temporal scales. These approaches reveal real-time dynamics of tumor evolution, providing new opportunities for therapeutic intervention. This review synthesizes key advances in understanding tumor heterogeneity: from its cellular origins and molecular mechanisms to its multidimensional manifestation in the tumor microenvironment and from metastatic heterogeneity to the fundamental causes of treatment resistance. We critically examine how these insights are informing novel therapeutic paradigms-including targeting clonal cooperative networks, modulating epigenetic plasticity and reprogramming metabolic adaptations. Finally, we outline future pathways toward precision medicine through the integration of multi-omics data and dynamic monitoring technologies. Ultimately, overcoming tumor heterogeneity necessitates reconceptualizing cancer not as a static collection of cells but as a dynamically evolving ecosystem.

Indexed as

Clonal EvolutionGenetic HeterogeneityNeoplasmsPrecision MedicineTumor MicroenvironmentAnimalsHumansMultiomicsNeoplastic Stem Cells

Identifiers

PMID42437748
PMCPMC13358051

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.