DOI: 10.1038/s41586-024-07861-8Central Idea: This paper investigates the coordinated inheritance of extrachromosomal DNAs (ecDNAs) in cancer cells, revealing that distinct ecDNA species co-segregate during mitosis, influenced by intermolecular interactions and transcription. This coordinated inheritance impacts oncogene co-amplification, ecDNA specialization, and responses to targeted therapy.Key Concepts:ecDNAs: Circular DNA molecules, common in cancer, driving oncogene amplification and intratumoral heterogeneity.ecDNA Species: Distinct ecDNA sequences within a cell, potentially carrying different oncogenes or regulatory elements.Co-segregation: The non-random, correlated inheritance of distinct ecDNA species into daughter cells during mitosis.Co-selection: The selective advantage conferred by the combined presence of multiple ecDNA species.Co-occurrence: The presence of multiple ecDNA species within the same cell or tumor.Intermolecular Interactions: Physical proximity and interaction between ecDNA species within the nucleus, particularly in ecDNA hubs.Transcriptional Influence: Active transcription at the start of mitosis facilitates ecDNA co-segregation.Enhancer-only ecDNAs: Specialized ecDNAs containing enhancer elements but no oncogenes, contributing to oncogene regulation through intermolecular interactions.Therapeutic Implications: Coordinated inheritance affects drug resistance mechanisms and informs therapeutic strategies for targeting cooperating oncogenes.Chromosomal Integration: ecDNA integration into chromosomes as a potential mechanism for escaping drug pressure and co-inheritance.Further Research/Unanswered Questions:Mechanism of Transcriptional Influence: Further investigate the precise mechanism by which transcription promotes co-segregation (e.g., specific protein factors involved).Generalizability to Other Episomes: Explore whether coordinated inheritance applies to other extrachromosomal elements like viral episomes or biomolecular condensates.Clinical Translation: Develop therapeutic strategies to exploit coordinated inheritance for improved cancer treatment (e.g., simultaneously targeting co-segregating oncogenes).Role in Cancer Evolution: Further investigate the contribution of coordinated inheritance to the overall dynamics of cancer evolution and adaptation.Higher-Order Interactions: Explore the potential for higher-order interactions between more than two ecDNA species and their impact on co-assortment.Long-term Effects of Drug Treatment: Investigate the long-term consequences of coordinated ecDNA dynamics under continuous and intermittent drug exposure.

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