Cell competition in carcinogenesis

Abstract The majority of human cancers evolve over time through the stepwise accumulation of somatic mutations followed by clonal selection akin to Darwinian evolution. However, the in-depth mechanisms that govern clonal dynamics and selection remain elusive, particularly during the earliest stages of tissue transformation. Cell competition, often referred to as 'survival of the fittest' at the cellular level, results in the elimination of less fit cells by their more fit neighbors supporting optimal organism health and function. Alternatively, cell competition may allow an uncontrolled expansion of super-fit cancer cells to outcompete their less fit neighbors thereby fueling tumorigenesis. Recent research discussed herein highlights the various non-cell autonomous principles, including inter-clonal competition and cancer-microenvironment competition supporting the ability of a tumor to progress from the initial stages to tissue colonization. Additionally, we extend current insights from cell competition-mediated clonal interactions and selection in normal tissues to better comprehend those factors that contribute to cancer development.