Preprint Article Version 1 This version is not peer-reviewed

Eradicating Metastatic Cancer and the Evolutionary Dynamics of Extinction

Version 1 : Received: 31 January 2019 / Approved: 1 February 2019 / Online: 1 February 2019 (10:29:06 CET)

How to cite: Gatenby, R.; Brown, J.S. Eradicating Metastatic Cancer and the Evolutionary Dynamics of Extinction. Preprints 2019, 2019020011 (doi: 10.20944/preprints201902.0011.v1). Gatenby, R.; Brown, J.S. Eradicating Metastatic Cancer and the Evolutionary Dynamics of Extinction. Preprints 2019, 2019020011 (doi: 10.20944/preprints201902.0011.v1).

Abstract

We propose the traditional goal of cancer therapists to develop a single drug or drug combination that can, by itself, eliminate all cancer cells within a host has neglected potential treatments that may achieve curative outcomes by strategically combining agents that are individually effective but non-curative. We derive basic principles for such an approach from the eco-evolutionary dynamics of background extinctions in which a “first strike” reduces the size and heterogeneity of the initial population and is followed immediately by demographic and ecological “second strikes” that push the population below an extinction threshold. This proposed strategy appears identical to the empirically-derived curative therapy in childhood Acute Lymphocytic Leukemia.

Subject Areas

Cancer treatment, resistance to treatment, evolution of resistance, background extinctions

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