A recent study suggests that adjusting the timing of cancer treatments may lead to better cure rates. The research was led by Dr Robert Noble, Senior Lecturer at the Department of Mathematics at City, St George's, University of London.
Currently, the common practice in cancer care is to wait until a tumor regrows before switching to a different treatment. By then, some tumor cells may have developed resistance mutations, making the next treatment less effective.
Dr Noble’s team explored an alternative based on evolutionary theory. Instead of waiting for resistance to appear, they propose switching treatments while the tumor is still responding to the initial therapy. This method, described as "kick it while it's down," is considered most suitable when doctors know that resistance often develops even with the best first-line options.
"Evolutionary approaches have been very successful in other contexts, such as combatting antibiotic resistance, or predicting what vaccines we should use in a particular flu season. There is every reason to suppose that similar approaches should work in tumors," Dr Noble said in a podcast about the study.
The researchers used mathematical models originally designed for studying how plants and animals adapt to environmental changes like climate shifts. Their findings indicate that this new strategy deserves more experimental and clinical testing. Currently, three small clinical trials are underway targeting soft-tissue cancer, prostate cancer, and breast cancer. Plans for additional trials are also progressing.
"Our models predict that this new approach will generally outperform the standard of care," Dr Noble stated. "A sequence of two treatments, even if optimally timed, is likely to succeed only in relatively small tumors. But we have reason to hope that switching between three or more treatments, following the same principle, could eliminate larger tumors."
