The Making of a PreCancer Atlas: Promises, Challenges, and Opportunities

There is a lack of in-depth knowledge of the early molecular, cellular, and non-cellular properties that fuel the progression of premalignant lesions to invasive cancers, resulting in a missed opportunity for intervention during this period. The PCA initiative will address this need by conducting comprehensive characterization of the molecular and cellular features of organ-specific premalignant lesions and their microenvironment, while also capturing the spatial and structural information temporally. The goal is to construct comprehensive, dynamic, high-resolution, multidimensional, multiparametric, temporal, and scalable atlases of precancerous lesions and their surrounding microenvironment. PCAs will lead to a greater understanding of the biological underpinnings of tumor progression or regression, and drive early detection, risk stratification, and intervention strategies. The PCA initiative was developed under the auspices of the Beau Biden Cancer MoonshotSM initiative. Many cancers evolve from benign precancerous lesions and have a natural history of progression that provides a window of opportunity for intervention. The biological mechanisms underlying this evolutionary trajectory can only be truly understood through an extensive characterization of the molecular, cellular, and non-cellular properties of premalignant and malignant tumors, and must also recognize how the microenvironment (stromal cells, immune cells, and other types of cells) contributes to this evolution. We describe here the need to develop comprehensive molecular and cellular atlases for organ-specific premalignant lesions while capturing the spatial, structural, and functional changes over time that will provide a greater understanding of how premalignancy transitions to malignancy. The PreCancer Atlas (PCA) initiative, described in this Opinion, will address this need and aims to overcome the many challenges that currently plague the field. The hope is that PCAs will lead to the development of effective and timely interventions to prevent the development of invasive cancers. Many cancers evolve from benign precancerous lesions and have a natural history of progression that provides a window of opportunity for intervention. The biological mechanisms underlying this evolutionary trajectory can only be truly understood through an extensive characterization of the molecular, cellular, and non-cellular properties of premalignant and malignant tumors, and must also recognize how the microenvironment (stromal cells, immune cells, and other types of cells) contributes to this evolution. We describe here the need to develop comprehensive molecular and cellular atlases for organ-specific premalignant lesions while capturing the spatial, structural, and functional changes over time that will provide a greater understanding of how premalignancy transitions to malignancy. The PreCancer Atlas (PCA) initiative, described in this Opinion, will address this need and aims to overcome the many challenges that currently plague the field. The hope is that PCAs will lead to the development of effective and timely interventions to prevent the development of invasive cancers. The Making of a PreCancer Atlas: Promises, Challenges, and Opportunities: (Trends in Cancer , 523–536, 2018)Srivastava et al.Trends in CancerFebruary 4, 2019In BriefIn the originally published article the footnote "On behalf of the HTAN Implementation Team" was missing. The online version of the article has been corrected with this information given here along with a list of the members of the HTAN Implementation Team. Full-Text PDF