Fig. 3.

Translational implications of heterogeneity in hepatocellular carcinoma (HCC). HCC heterogeneity promotes cancer progression—multiple subclones are present and the evolution of subclones with metastatic potential can lead to metastasis. Consequently, patients with high heterogeneity have a greater degree of cancer progression and poorer prognoses. Heterogeneity impedes biomarker development—a single tissue biopsy often doesn’t capture tumor heterogeneity, and this limited insight into the tumor complicates patient stratification and biomarker development. Heterogeneity limits therapeutic efficacy—therapies can apply selective pressure on the tumor, leading to the evolution of resistant subclones.