The Swanton/Quezada laboratories are studying the evolution of tumours from a single cell to a large tumor containing hundreds of billions of cells. Mutations in DNA that occur early in tumour evolution are present in every cell, however those occurring later in tumour evolution are present in some cells but not others. This leads to substantial genetic diversity between cancer cells within the same patient, which acts as the foundation for selection and drug resistance. The laboratory is exploring the common mutations present across all tumour cells in a patient at every site of disease that may act as flags to alert the immune system to destroy the whole tumor rather than parts of the tumour. The laboratory is finding ways to utilise the immune system to combat these common flags on the cell surface using T and B immune cell approaches. Central to this work will be the determination of how T cells recognise these common flags on the cell surface and how cancers regulates the activity of these “killer” T cells and suppress their behaviour. Their research over the next five years will decipher rules that regulate these processes in order to develop bespoke therapies on a patient by patient basis, with the intention of improving outcomes in advanced metastatic disease.