Alberto Bardelli, PhD, from the University of Torino, Candiolo Cancer Institute, Turin, Italy, discusses clonal evolution of tumor cells and drug resistance at the European Society for Medical Oncology (ESMO) 2017 in Madrid, Spain. Clonal evolution is directly linked to the development of drug resistance in cancer. It was discovered that one mechanism of resistance was linked to a secondary mutation in the oncogene KRAS, and research was done on EGFR blockade in colorectal cancer. The evolution of these clones can be tracked using ctDNA analysis, back to the molecular mechanism that can led to this evolution.