Integrating evolutionary dynamics into cancer therapy
Cet article décrit plusieurs stratégies, basées sur les principes évolutionnistes et consistant à orienter l'évolution des tumeurs, pour réduire le risque d'acquisition d'une résistance thérapeutique et contrôler la progression de la maladie
Many effective drugs for metastatic and/or advanced-stage cancers have been developed over the past decade, although the evolution of resistance remains the major barrier to disease control or cure. In large, diverse populations such as the cells that compose metastatic cancers, the emergence of cells that are resistant or that can quickly develop resistance is virtually inevitable and most likely cannot be prevented. However, clinically significant resistance occurs only when the pre-existing resistant phenotypes are able to proliferate extensively, a process governed by eco-evolutionary dynamics. Attempts to disrupt the molecular mechanisms of resistance have generally been unsuccessful in clinical practice. In this Review, we focus on the Darwinian processes driving the eco-evolutionary dynamics of treatment-resistant cancer populations. We describe a variety of evolutionarily informed strategies designed to increase the probability of disease control or cure by anticipating and steering the evolutionary dynamics of acquired resistance.
Dans cette revue, nous nous concentrons sur les processus darwiniens à l'origine de la dynamique éco-évolutive des populations cancéreuses résistantes aux traitements. Nous décrivons une variété de stratégies évolutives conçues pour augmenter la probabilité de contrôle ou de guérison de la maladie en anticipant et en dirigeant la dynamique évolutive de la résistance acquise.
Nature Reviews Clinical Oncology , résumé, 2020