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Comparing the genomes of primary tumours and their metastases put numbers on the timeline: about ten years from the first mutation to a fully formed tumour, five more before it can spread, and two years of life after that, so there is a long window in which the cancer could be caught.
The genomes of seven pancreatic cancer metastases were sequenced to evaluate clonal relationships among primary and metastatic cancers. Clonal populations giving rise to distant metastases were represented within the primary carcinoma but were genetically evolved from the original parental non-metastatic clone, so the genetic heterogeneity of metastases reflects that within the primary. Quantitative analysis indicated at least a decade between the initiating mutation and the birth of the parental non-metastatic founder cell, at least five more years for metastatic ability, and death an average of two years thereafter.
It is the quantitative case for early detection: the biology allows a fifteen-year window, and the disease is lethal because we look too late, not because it moves fast.
Shares High-risk pancreatic surveillance (CAPS / PRECEDE), Clonal evolution & minimal residual disease, Nature, Johns Hopkins Hospital / Sidney Kimmel Comprehensive Cancer Center.
Shares Bert Vogelstein, Clonal evolution & minimal residual disease, Johns Hopkins Hospital / Sidney Kimmel Comprehensive Cancer Center, Whole-exome & whole-genome sequencing.
Shares High-risk pancreatic surveillance (CAPS / PRECEDE), Clonal evolution & minimal residual disease, Johns Hopkins Hospital / Sidney Kimmel Comprehensive Cancer Center, Whole-exome & whole-genome sequencing.
Shares Kenneth W. Kinzler, Bert Vogelstein, Johns Hopkins Hospital / Sidney Kimmel Comprehensive Cancer Center, Pancreatic ductal adenocarcinoma.
Shares High-risk pancreatic surveillance (CAPS / PRECEDE), Johns Hopkins Hospital / Sidney Kimmel Comprehensive Cancer Center, Whole-exome & whole-genome sequencing, Pancreatic ductal adenocarcinoma.
Shares The metastatic cascade, Johns Hopkins Hospital / Sidney Kimmel Comprehensive Cancer Center, Metastatic pancreatic ductal adenocarcinoma, Pancreatic ductal adenocarcinoma.
Shares Kenneth W. Kinzler, Bert Vogelstein, Johns Hopkins Hospital / Sidney Kimmel Comprehensive Cancer Center, Pancreatic ductal adenocarcinoma.
Shares Kenneth W. Kinzler, Bert Vogelstein, Johns Hopkins Hospital / Sidney Kimmel Comprehensive Cancer Center, Pancreatic ductal adenocarcinoma.