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Article

Modifying Adaptive Therapy to Enhance Competitive Suppression

by 1,* and 1,2,3
1
Department of Biology, Pennsylvania State University, University Park, PA 16802, USA
2
Huck Institutes of the Life Sciences, Pennsylvania State University, University Park, PA 16802, USA
3
Department of Entomology, Pennsylvania State University, University Park, PA 16802, USA
*
Author to whom correspondence should be addressed.
Cancers 2020, 12(12), 3556; https://doi.org/10.3390/cancers12123556
Received: 26 October 2020 / Revised: 20 November 2020 / Accepted: 26 November 2020 / Published: 28 November 2020
Adaptive therapy is a new approach to cancer treatment that aims to forestall treatment resistance by controlling instead of minimizing tumor burdens. The underlying hypothesis is that drug-sensitive cancer cells can competitively suppress drug-resistant cells and greatly increase the amount of time that a therapy is effective. This approach is being tested in a clinical trial, and the preliminary results are extremely promising. If these promising results can indeed be attributed to the competitive suppression of resistance, then identifying simple ways to enhance competitive suppression should increase the benefits of this therapy. Here, we show that simple modifications to the design of adaptive therapy should greatly enhance its performance and also increase the range of patients who can benefit from it. Importantly, this investigation also highlights key assumptions underlying the design of adaptive therapy and emphasizes that these must be validated if adaptive therapy is to be optimized and used effectively.
Adaptive therapy is a promising new approach to cancer treatment. It is designed to leverage competition between drug-sensitive and drug-resistant cells in order to suppress resistance and maintain tumor control for longer. Prompted by encouraging results from a recent pilot clinical trial, we evaluate the design of this initial test of adaptive therapy and identify three simple modifications that should improve performance. These modifications are designed to increase competition and are easy to implement. Using the mathematical model that supported the recent adaptive therapy trial, we show that the suggested modifications further delay time to tumor progression and also increase the range of patients who can benefit from adaptive therapy. View Full-Text
Keywords: competition; resistance; treatment regimen; adaptive therapy competition; resistance; treatment regimen; adaptive therapy
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MDPI and ACS Style

Hansen, E.; Read, A.F. Modifying Adaptive Therapy to Enhance Competitive Suppression. Cancers 2020, 12, 3556. https://doi.org/10.3390/cancers12123556

AMA Style

Hansen E, Read AF. Modifying Adaptive Therapy to Enhance Competitive Suppression. Cancers. 2020; 12(12):3556. https://doi.org/10.3390/cancers12123556

Chicago/Turabian Style

Hansen, Elsa, and Andrew F. Read. 2020. "Modifying Adaptive Therapy to Enhance Competitive Suppression" Cancers 12, no. 12: 3556. https://doi.org/10.3390/cancers12123556

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