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152883 - Is adaptive therapy natural.pdf (2.79 MB)

Is adaptive therapy natural?

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posted on 2023-05-21, 13:03 authored by Thomas, F, Donnadieu, E, Charriere, GM, Jacqueline, C, Tasiemski, A, Pujol, P, Renaud, F, Roche, B, Rodrigo Hamede RossRodrigo Hamede Ross, Brown, J, Gatenby, R, Ujvari, B
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 organism's death due to cancer. We propose that organisms' 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 body's 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 body's NAT and accelerates the evolution of immune resistance.


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PLoS Biology





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School of Natural Sciences


Public Library of Science

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United States

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© 2018 Thomas et al. This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) License, (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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