Evolution and heterogeneity of lethal metastatic bladder cancer subtypes

A team publishing in Nature examined tissue collected shortly after the death of patients with metastatic bladder cancer and traced how the same tumour changes across metastatic sites and over the course of treatment. The work shows at what point the tumour shifts into more aggressive histological subtypes and by which routes it acquires resistance to therapy. This is a descriptive study: it does not change patient management today, but it creates a resource from which work on overcoming resistance can start.