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Species go extinct when a second disaster hits a population already shrunk by a first one. Apply the same logic: hit the tumour with a different kind of drug when it is smallest, rather than waiting for it to grow back.
The first-strike, second-strike model from extinction biology proposes that a therapy switch at nadir, when the residual population is small and less diverse, exploits stochastic extinction and pre-empts the expansion of resistant clones. Current practice continues the first drug until progression, when the population is large and resistant. A trial would randomise patients at best response to a mechanistically distinct second strike versus continuation.
Shares Moffitt Cancer Center, Tumour heterogeneity and clonal evolution.
Shares Tumour heterogeneity and clonal evolution, Acquired resistance to every therapy, Melanoma, Non-small-cell lung cancer.
Shares Tumour heterogeneity and clonal evolution, Acquired resistance to every therapy, Melanoma, Non-small-cell lung cancer.
Shares Moffitt Cancer Center, Tumour heterogeneity and clonal evolution, Melanoma.
Shares Moffitt Cancer Center, Melanoma.
Shares Moffitt Cancer Center, Acquired resistance to every therapy, Melanoma.
Shares Tumour heterogeneity and clonal evolution, Acquired resistance to every therapy, Non-small-cell lung cancer.