METASTATIC cancer patient outcomes could be improved by applying the principles of evolutionary ‘game theory’ to therapies, a study from Maastricht University, Maastricht, Netherlands in collaboration with the Moffitt Cancer Center, Florida, USA has suggested. The researchers believe that by assuming the role of leader and anticipating future responses by cancer cells to treatments, physicians can delay or even prevent resistance developing.
Physicians Staying Ahead
In their analysis, the team showed that physicians can use their understanding of evolution to anticipate how cancer cells will adapt to a particular treatment. Using these insights, they can then administer the therapy strategically to prevent resistance occurring, staying ahead of the cancer cells in the game. Unlike cancer cells, which are only able to react to the present environment, physicians hold the key advantage of being able to consider future events. The researchers hope that these findings will lead to changes to the ways in which clinics treat metastatic cancers.
“This study shows that physicians can exploit the advantages inherent in the asymmetries of the cancer treatment game, and likely improve outcomes, by adopting more dynamic treatment protocols that integrate eco-evolutionary dynamics and modulate therapy accordingly,” commented Dr Robert Gatenby, Moffitt Cancer Center.
Current Standard Practice
Currently, the standard practice for treating metastatic cancer is to administer drugs at the maximum-tolerated dose (MTD). This technique, in which doses are often given continually or in repeated cycles, is thought to accelerate the development of resistance by cancer cells.
“By playing the same strategy repeatedly, current treatments for metastatic cancers greatly increase the speed with which cancer cells can evolve effective counter measures,” explained Dr Gatenby. “In fact, therapy is usually changed only when the tumour progresses. Ironically, by using this strategy the physician cedes control of the game to the cancer. In effect, the physician becomes the follower. Although standard practice for decades, administering drugs at MTD until progression represents a poor strategy for most metastatic cancers.”
Further Study
The authors added that the game theory strategy could also be applicable to other forms of cancer, particularly aggressive and heterogeneous cancers; they hope to make such discoveries as they continue their work in this area.
James Coker, Reporter
For the source and further information about the study, click here.
