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Scrutinizing malignant tissues

Published online 15 September 2016

Scientists develop an autopsy-based program that can uncover secrets of stubborn cancers.

Islam Elkholi

A new study presents a promising autopsy model dubbed Cancer Tissue Collection After Death (CASCADE) that scientists say can deliver vital information about resistant cancers. The program targets end-stage cancer patients who are willing to donate tissues after death. 

Cancerous tissues have dynamic heterogeneity, meaning that cellular variants are selected within the tumour in response to changes in their environment, including the stress induced by anti-cancer treatments. This feature leads to chemoresistance, which has been puzzling scientists for many years.

The fact that end-stage cancer patients are non-operable means that tumour samples cannot be acquired, making it difficult to identify factors underlying a tumour's aggressive behaviour. 

In this study1, the researchers from Australia, Canada and Saudi Arabia describe a well-defined process that ensures obtaining and processing samples from deceased patients in a timely manner without infringing any ethical codes. 

The obtained autopsies can then be assessed pathologically and genetically to identify acquired mutations. 

"Approximately 110,000 women die each year with high grade serous ovarian cancer but until now we’ve had no detailed understanding of the cancer that kills them," says principal investigator, David Bowtell, from the Peter MacCallum Cancer Centre, Australia. 

"We are seeing changes that can’t be predicted from an analysis of primary tumour material.  However, autopsy sampling allows us to integrate the selective impact of all their chemotherapy and to understand the intrapatient ecosystem of resistance occurring in late stage disease," adds Bowtell.


  1. Alsop K. et al. A community-based model of rapid autopsy in endstage cancer patients. Nat. Biotechnol. (2016).