Cancer biology as revealed by the research autopsy

A research autopsy is a post-mortem medical procedure performed on a deceased individual with the primary goal of collecting tissue to support basic and translational research. This approach has increasingly been used to investigate the pathophysiological mechanisms of cancer evolution, metastasis a...

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Published in:Nature reviews. Cancer Vol. 19; no. 12; pp. 686 - 697
Main Authors: Iacobuzio-Donahue, Christine A, Michael, Chelsea, Baez, Priscilla, Kappagantula, Rajya, Hooper, Jody E, Hollman, Travis J
Format: Journal Article
Language:English
Published: England Nature Publishing Group 01.12.2019
Subjects:
Animals
Autopsy
Biomarkers, Tumor - metabolism
Cancer
Carcinogenesis
Drug Resistance, Neoplasm
Evolution, Molecular
Humans
Medical research
Metastases
Neoplasm Metastasis
Neoplasms - genetics
Neoplasms - physiopathology
Neoplasms - therapy
Patients
Precision Medicine
Research Design
Specimen Handling
Treatment resistance
Tumors
ISSN:1474-175X, 1474-1768, 1474-1768
Online Access:Get full text
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Summary:A research autopsy is a post-mortem medical procedure performed on a deceased individual with the primary goal of collecting tissue to support basic and translational research. This approach has increasingly been used to investigate the pathophysiological mechanisms of cancer evolution, metastasis and treatment resistance. In this Review, we discuss the rationale for the use of research autopsies in cancer research and provide an evidence-based discussion of the quality of post-mortem tissues compared with other types of biospecimens. We also discuss the advantages of using post-mortem tissues over other types of biospecimens, including the large amounts of tissue that can be obtained and the extent of multiregion sampling that is achievable, which is not otherwise possible in living patients. We highlight how the research autopsy has supported the identification of the clonal origins and modes of spread among metastases, the extent that selective pressures imposed by treatments cause bottlenecks leading to parallel and convergent tumour evolution, and the creation of rare tissue banks and patient-derived model systems. Finally, we comment on the future of the research autopsy as an integral component of precision medicine strategies.
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ISSN:1474-175X
1474-1768
1474-1768
DOI:10.1038/s41568-019-0199-4