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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
Summary
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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