ReviewCancers2021
Tumor Heterogeneity: A Great Barrier in the Age of Cancer Immunotherapy.
Review in Cancers, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 103 papers.
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.
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.
Who cites it
103 citing papers in PubMed.
- Opportunities and challenges for cancer immunotherapy based on antigen cross-presentation.Annals of medicine · 2026Review
- CRISPR-Cas9 in Cancer Therapy: Overcoming Delivery Barriers and Off-Target Effects for Clinical Translation.Health science reports · 2026Article
- Phylogenetic and phylodynamic approaches to understanding the evolution of non-small cell lung cancer using single-cell sequencing.Oncogene · 2026Article
- High-spatiotemporal resolution deuterium metabolic imaging enables in vivo phenotyping of intra- and intertumoral heterogeneity.Science advances · 2026Article
- Immunotherapy for Cancer: Current Advances and Future Directions.International journal of molecular sciences · 2026Review
- From veterinary antibiotic to cancer therapy: revisiting anticancer potential of Monensin.Molecular biology reports · 2026Review
- Application of metal-based nanoparticles in targeted drug delivery to breast cancer stem cells.Discover nano · 2026Review
- Beyond PD-1/PD-L1: Reprogramming the Gynecologic Tumor Microenvironment by Targeting TIGIT and Myeloid Suppression.International journal of molecular sciences · 2026Review
- Alternative Splicing of the NF-Y Subunit, NF-YA, in Neuroblastoma Phenotype Heterogeneity.Cancers · 2026Review
- Piperazine derivatives as anticancer agents: a medicinal chemistry review of structure, mechanism, and clinical translation.Medicinal chemistry research : an international journal for rapid communications on design and mechanisms of action of biologically active agents · 2026Review
- Cell surface thiol-disulfide regulation in cancer: Mechanisms, implications, and theranostic strategies.Redox biology · 2026Review
- Harnessing Cancer Stem Cells and 3D Organoids in Unravelling Spatial and Cellular Heterogeneity in Cancer.International journal of molecular sciences · 2026Review
- Tumor Genomics and Liquid Biopsy in Cancer Biology: From Static Snapshots to Dynamic Measurements.Biomolecules · 2026Article
- GPA33-Targeted Trimeric Immunotoxin Exhibits Enhanced Antitumor Activity in Human Colorectal Cancer Xenografts.International journal of molecular sciences · 2026Article
- Advancing adoptive T cell therapy in ovarian cancer: barriers, innovations, and emerging platforms.Journal for immunotherapy of cancer · 2026Review
- CD24 as an innate immune checkpoint in solid tumors: biology, biomarker stratification, and therapeutic translation.Frontiers in immunology · 2026Review
- From Tumor to Tumor-Spleen: MRI Habitat Heterogeneity for Predicting Immunotherapy Outcome in Advanced Hepatocellular Carcinoma.Journal of hepatocellular carcinoma · 2026Article
- Tumor microenvironment conversion through intelligent nanomedicine: a paradigm shift in overcoming chemoresistance.Frontiers in oncology · 2026Review
- IGLC3Frontiers in immunology · 2026Article
- Intratumoral and peritumoral heterogeneity based on CT to predict the pathological response after neoadjuvant chemoimmunotherapy in esophageal squamous cell carcinoma.International journal of surgery (London, England) · 2026Article
43 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Throughout the history of oncology research, tumor heterogeneity has been a major hurdle for the successful treatment of cancer. As a result of aberrant changes in the tumor microenvironment such as high mutational burden, hypoxic conditions and abnormal vasculature, several malignant subpopulations often exist within a single tumor mass. Therapeutic intervention can also increase selective pressure towards subpopulations with acquired resistance. This phenomenon is often the cause of relapse in previously responsive patients, drastically changing the expected outcome of therapy. In the case of cancer immunotherapy, tumor heterogeneity is a substantial barrier as acquired resistance often takes the form of antigen escape and immunosuppression. In an effort to combat intrinsic resistance mechanisms, therapies are often combined as a multi-pronged approach to target multiple pathways simultaneously. These multi-therapy regimens have long been a mainstay of clinical oncology with chemotherapy cocktails but are more recently being investigated in the emerging landscape of immunotherapy. Furthermore, as high throughput technology becomes more affordable and accessible, researchers continue to deepen their understanding of the factors that influence tumor heterogeneity and shape the TME over the course of treatment regimens. In this review, we will investigate the factors that give rise to tumor heterogeneity and the impact it has on the field of immunotherapy. We will discuss how tumor heterogeneity causes resistance to various treatments and review the strategies currently being employed to overcome this challenging clinical hurdle. Finally, we will outline areas of research that should be prioritized to gain a better understanding of tumor heterogeneity and develop appropriate solutions.
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Registered trials
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 OpenQuestion graph.