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Adaptive therapy: a tumor therapy strategy based on Darwinian evolution theory

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ELSEVIER SCIENCE INC
DOI: 10.1016/j.critrevonc.2023.104192

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Adaptive therapy; Tumor evolution; Resistance cost; Evolutionary game theory; Mathematical models

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Cancer progression is a dynamic and evolving process that generates genetic diversity and heterogeneity through clonal and subclonal amplification based on random mutations. Traditional cancer treatment methods face the challenge of drug resistance, therefore integrating evolutionary dynamics into treatment regimens may be an effective approach. Adaptive therapy, as a potential treatment strategy, adjusts treatment cycles according to tumor evolution to control the growth of treatment-resistant cells.
Cancer progression is a dynamic process of continuous evolution, in which genetic diversity and heterogeneity are generated by clonal and subclonal amplification based on random mutations. Traditional cancer treatment strategies have a great challenge, which often leads to treatment failure due to drug resistance. Integrating evolutionary dynamics into treatment regimens may be an effective way to overcome the problem of drug resistance. In particular, a potential treatment is adaptive therapy, which strategy advocates containment strategies that adjust the treatment cycles according to tumor evolution to control the growth of treatment-resistant cells. In this review, we first summarize the shortcomings of traditional tumor treatment methods in evolution and then introduce the theoretical basis and research status of adaptive therapy. By analyzing the limitations of adaptive therapy and exploring possible solutions, we can broaden people's understanding of adaptive therapy and provide new insights and strategies for tumor treatment.

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