Loading
Instead of hitting a tumour as hard as possible, adaptive therapy gives just enough drug to keep it in check and stops when it shrinks, so drug-sensitive cells survive to compete with resistant ones. A pilot trial in prostate cancer roughly doubled the time to progression on abiraterone.
Robert Gatenby and colleagues at Moffitt proposed in 2009 that maximum-tolerated-dose therapy selects for resistance by eliminating the sensitive cells that would otherwise suppress resistant ones through competition. Adaptive therapy uses tumour burden (PSA, imaging) to modulate dosing: treat until the marker halves, pause, resume when it returns. Zhang and colleagues' pilot trial (2017) in metastatic castration-resistant prostate cancer gave abiraterone adaptively and reported a median time to progression of about 30 months against roughly 14 in contemporaneous continuous-dosing patients, using about half the drug. Randomised trials in prostate cancer (ANZadapt), melanoma and other tumours are under way, and the approach depends on mathematical models of competition to set thresholds.
Lotka-Volterra competition between sensitive and resistant clones: keeping a sensitive population alive imposes a fitness cost on resistant cells, delaying their takeover; dosing is adjusted to hold the tumour at a stable burden.
One technology page, one pathway page and one term page on OnCo cite this paper by its DOI; this record gives the citation a page of its own so a reader can follow it without leaving OnCo. Read the abstract above alongside the citing pages listed under Related; the record was created automatically from the Europe PMC entry and its figures have not been checked by hand.
One technology page and one term page on OnCo cite this paper by its DOI; this record gives the citation a page of its own so a reader can follow it without leaving OnCo. Read the abstract above alongside the citing pages listed under Related; the record was created automatically from the Europe PMC entry and its figures have not been checked by hand.
Query for this technology: (TITLE:"Adaptive therapy" OR ABSTRACT:"Adaptive therapy" OR TITLE:"evolution-based dosing" OR ABSTRACT:"evolution-based dosing") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Adaptive therapy (evolution-based dosing), not a curated reading list.
Shares Evolutionary dynamics of drug resistance, Tumour clonal evolution tracking, Mathematical models of cancer (mathematical oncology) and the tag mathematical-model.
Shares Tumour clonal evolution tracking, Mathematical models of cancer (mathematical oncology), Clonal evolution and the ecological view of cancer and the tag mathematical-model.
Shares Tumour clonal evolution tracking, Mathematical models of cancer (mathematical oncology), Melanoma and the tag mathematical-model.
Shares Patient digital twins, Mathematical models of cancer (mathematical oncology) and the tag mathematical-model.
Shares Patient digital twins, Mathematical models of cancer (mathematical oncology) and the tag mathematical-model.
Shares Mathematical models of cancer (mathematical oncology) and the tag mathematical-model.
Shares Mathematical models of cancer (mathematical oncology) and the tag mathematical-model.
Shares Mathematical models of cancer (mathematical oncology) and the tag mathematical-model.