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Integrating evolutionary dynamics into cancer therapy

Robert A Gatenby1,2,3, Joel S Brown4,5,6

  • 1Cancer Biology and Evolution Program, Moffitt Cancer Center, Tampa, FL, USA. robert.gatenby@moffitt.org.

Nature Reviews. Clinical Oncology
|July 24, 2020
PubMed

Insights

Cancer treatment resistance is inevitable, but understanding its eco-evolutionary dynamics can help control tumor growth. This review explores Darwinian principles to develop strategies against treatment-resistant cancers.

Area of Science:

  • Oncology
  • Evolutionary Biology
  • Cancer Research

Background:

  • Effective cancer drugs exist, but resistance limits treatment success.
  • Cancer cells' diversity makes resistance emergence unavoidable.
  • Clinically significant resistance arises from the proliferation of resistant cells, driven by eco-evolutionary dynamics.

Purpose of the Study:

  • To review the Darwinian processes underlying treatment-resistant cancer populations.
  • To explore evolutionarily informed strategies for managing acquired resistance.
  • To improve disease control or cure by anticipating cancer's evolutionary dynamics.

Main Methods:

  • Review of existing literature on cancer resistance.
  • Analysis of eco-evolutionary dynamics in metastatic cancers.
  • Focus on Darwinian principles driving resistance.

Main Results:

  • Resistance evolution in cancer is a natural Darwinian process.
  • Eco-evolutionary dynamics govern the proliferation of resistant cancer cells.
  • Disrupting resistance mechanisms has had limited clinical success.

Conclusions:

  • Managing cancer resistance requires understanding its evolutionary nature.
  • Evolutionarily informed strategies can improve treatment outcomes.
  • Anticipating and steering resistance dynamics is key to long-term disease control.

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