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Integrating evolutionary principles into clinical cancer treatment protocols

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  • Integrating evolutionary principles into clinical cancer treatment protocols
    Thomas F, Donnadieu E, Charriere GM, et al. Is adaptive therapy natural?. PLoS Biol. 2018;16(10):e2007066. Published 2018 Oct 2. doi:10.1371/journal.pbio.2007066

    Research suggests that progression-free survival can be prolonged by integrating evolutionary principles into clinical cancer treatment protocols. The goal is to prevent or slow the proliferation of resistant malignant cell populations. The logic behind this therapy relies on ecological and evolutionary processes. These same processes would be available to natural selection in decreasing the probability of an organismís death due to cancer. We propose that organismsí anticancer adaptions include not only ones for preventing cancer but also ones for directing and retarding the evolution of life-threatening cancer cells. We term this last strategy natural adaptive therapy (NAT). The bodyís NAT might include a lower than otherwise possible immune response. A restrained immune response might forego maximum short-term kill rates. Restraint would forestall immune-resistant cancer cells and produce long-term durable control of the cancer population. Here, we define, develop, and explore the possibility of NAT. The discovery of NAT mechanisms could identify new strategies in tumor prevention and treatments. Furthermore, we discuss the potential risks of immunotherapies that force the immune system to ramp up the short-term kill rates of malignant cancer cells in a manner that undermines the bodyís NAT and accelerates the evolution of immune resistance.
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    “‘i love myself.’ the quietest. simplest. most powerful. revolution ever.” ---- nayyirah waheed

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