# Clonal Heterogeneity and Tumor Evolution: Past, Present, and the Future

Source: https://onco.cc/key-papers/paper-mcgranahan-cell/  
OnCo record `paper-mcgranahan-cell` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Paper cited by one bottleneck page, indexed on Europe PMC as PubMed record 28187284 and published in Cell; the citing page links this DOI, which is how the record was matched.

## Summary

Intratumor heterogeneity, which fosters tumor evolution, is a key challenge in cancer medicine. Here, we review data and technologies that have revealed intra-tumor heterogeneity across cancer types and the dynamics, constraints, and contingencies inherent to tumor evolution. We emphasize the importance of macro-evolutionary leaps, often involving large-scale chromosomal alterations, in driving tumor evolution and metastasis and consider the role of the tumor microenvironment in engendering heterogeneity and drug resistance. We suggest that bold approaches to drug development, harnessing the adaptive properties of the immune-microenvironment while limiting those of the tumor, combined with advances in clinical trial-design, will improve patient outcome.

Indexed on Europe PMC as PubMed record 28187284 (DOI 10.1016/j.cell.2017.01.018). Matched by DOI alone: one bottleneck page cites this DOI among its external links (the pages are listed under Related), and this page was written so that the citation resolves inside OnCo. No figure has been checked by an editor.

## Fields

- Kind: Key paper
- Last checked: 2026-09-22
- Tags: europepmc-ingest
- Journal: Cell
- Year: 2017
- DOI: 10.1016/j.cell.2017.01.018
- Authors: McGranahan N, Swanton C
- What it means: One bottleneck page on OnCo cites this paper by its DOI; this record gives the citation a page of its own so a reader can follow it without leaving OnCo. Read the abstract above alongside the citing page listed under Related; the record was created automatically from the Europe PMC entry and its figures have not been checked by hand.
- Caveats: Matched to the citing OnCo records by DOI alone; the summary reproduces the Europe PMC abstract and no figure has been verified against the full paper.

## Sources

- Cell 2017: https://doi.org/10.1016/j.cell.2017.01.018
- PubMed: https://pubmed.ncbi.nlm.nih.gov/28187284/
- Europe PMC: https://europepmc.org/article/MED/28187284

## Connected records

- bottlenecks: [Tumour heterogeneity and clonal evolution](https://onco.cc/bottlenecks/b-tumor-heterogeneity/)
- journals: [Cell](https://onco.cc/journals/cell/)

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