Fig. 5

Model of clonal progression of cervical cancer. Normal cervical cells may harbor genomic alterations and HPV integration after HPV infection. Some cells regress to normal spontaneously, while others round into clonally invasive carcinoma cells. Overwhelming majority cancer cells are removed or killed during conventional surgery and chemoradiotherapy. A few dormant or new subclones develop into recurrent, persist or metastatic cancer lesions. Systemic therapies (chemotherapy, radiotherapy, biotherapy and immunological therapy) can induce intrinsic or adapted resistant subclones. Resistant subclones contribute to uncontrolled disease and treatment failure