An interesting new cancer research study published by a team of researchers from the Moffitt Cancer Center puts forth an idea for a new approach to the treatment of cancer. It’s what many are calling an “evolutionary approach”, and it is less toxic than the normal approach to treatment with chemotherapy. The theory is that aggressive chemotherapy treatments kill all of the cancer cells that can’t survive the drug, leaving the strongest, most resistant cells alone to multiply and take over. The study was published in the journal Science Translational Research in February of this year.
This new approach to cancer treatment that the researchers refer to as an “adaptive strategy” is to treat the cancer with short bursts of chemotherapy, allowing some of the cancer cells that aren’t resistant to the drug to remain and keep the cells that are resistant at bay. By using the old approach of aggressively treating a tumor and then stopping once the cancer responds, physicians have let evolution take its course, allowing the fittest cancer cells to survive and reproduce. The idea of treating cancer with an adaptive strategy is to keep the cancer under control rather than attempting to completely destroy it with chemotherapy, which also takes a toll on the patient.
Breast Cancer Study
The study, which was done on mice with triple-negative breast cancer (not responsive to estrogen) and estrogen positive breast cancer. Some mice were given standard treatment with paclitaxel which involved the standard maximum dose and other mice were treated using the evolutionary or adaptive approach in which they were given the normal starting dose, and then the medication was slowly decreased over time. They found that the mice that were treated using the adaptive approach lived much longer. Some were even able to discontinue the medication.
"According to evolutionary principles, high-dose therapy is least likely to be successful in controlling the tumor for any length of time because it intensely selects for resistant cells and allows them to grow rapidly because the treatment has eliminated all of its competitors," corresponding author Robert Gatenby, MD, said in a Moffitt press release. The press release also contains an overview of the study and how it was conducted.
Going Forward with an Adaptive Treatment Strategy
While treating cancer from an evolutionary standpoint may be a novel approach, the idea that cancer is an evolutionary process within our bodies isn’t new. Many books and publications have touched on this subject since 2006, as can be seen on the University of Berkeley’s website. Perhaps being able to control cancer’s evolutionary process and limit “the survival of the fittest” doctors can control some cancers that would otherwise be fatal, and all while giving patients a better quality of life. After doing this study on breast cancer, the research team is now pursuing a study on prostate cancer using the same treatment methodology.