Evolution of resistance to targeted anti-cancer therapies during continuous and pulsed administration strategies Journal Article


Authors: Foo, J.; Michor, F.
Article Title: Evolution of resistance to targeted anti-cancer therapies during continuous and pulsed administration strategies
Abstract: The discovery of small molecules targeted to specific oncogenic pathways has revolutionized anti-cancer therapy. However, such therapy often fails due to the evolution of acquired resistance. One long-standing question in clinical cancer research is the identification of optimum therapeutic administration strategies so that the risk of resistance is minimized. In this paper, we investigate optimal drug dosing schedules to prevent, or at least delay, the emergence of resistance. We design and analyze a stochastic mathematical model describing the evolutionary dynamics of a tumor cell population during therapy. We consider drug resistance emerging due to a single (epi)genetic alteration and calculate the probability of resistance arising during specific dosing strategies. We then optimize treatment protocols such that the risk of resistance is minimal while considering drug toxicity and side effects as constraints. Our methodology can be used to identify optimum drug administration schedules to avoid resistance conferred by one (epi)genetic alteration for any cancer and treatment type. © 2009 Foo, Michor.
Keywords: gene mutation; genetics; antineoplastic agents; antineoplastic agent; neoplasm; neoplasms; animal; metabolism; animals; biological model; statistics; neoplasm proteins; clinical protocol; drug resistance; drug resistance, neoplasm; cell population; cancer therapy; cancer resistance; evolution, molecular; molecular evolution; probability; epigenetics; epigenesis, genetic; cancer cell; tumor protein; models, genetic; computer simulation; drug administration; drug pulse therapy; dynamics; stochastic model; genetic epigenesis; stochastic processes
Journal Title: PLoS Computational Biology
Volume: 5
Issue: 11
ISSN: 1553-7358
Publisher: Public Library of Science  
Date Published: 2009-11-01
Start Page: e1000557
Language: English
DOI: 10.1371/journal.pcbi.1000557
PUBMED: 19893626
PROVIDER: scopus
PMCID: PMC2766072
DOI/URL:
Notes: --- - "Cited By (since 1996): 2" - "Export Date: 30 November 2010" - "Art. No.: e1000557" - "Source: Scopus"
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  1. Franziska Michor
    23 Michor
  2. Jasmine Yen-Teng Foo
    6 Foo