Neutral evolution of rare cancer mutations in the computer and the clinic.

Abstract

A distinct model of neutral evolution of rare cancer mutations is described and contrasted with models relying on the infinite sites approximation (that a specific mutation arises in only one cell at any instant). An explosion of genetic diversity is predicted at clinical cell numbers and may explain the progressive refractoriness of cancers during a clinical course. The widely used infinite sites assumption may not be applicable for clinical cancers.