Skip to main content
. Author manuscript; available in PMC: 2014 May 2.
Published in final edited form as: Nat Rev Cancer. 2011 May 19;11(6):450–457. doi: 10.1038/nrc3063

Figure 1. Cascade of mutations during tumour progression.

Figure 1

In the case of solid tumours, epidemiological evidence indicates that as many as 20 years pass between the time an individual is exposed to a carcinogen to the clinical appearance of a tumour. Various barriers to tumour progression exist, including DNA repair processes, the availability of nutrition, the requirement of angiogenesis to allow the tumour to increase in size and responses to hypoxia. Circles represent mutations in genes that result in enhanced mutagenesis, triangles indicate driver mutations that are selected on the basis of changes in the tumour microenvironment and white rectangles represent passenger mutations.