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Moffitt’s Top Research Developments of 2017: Less is More: Adaptive Therapy

December 22, 2017

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2017 saw important discoveries in the battle against cancer, some of them using elements of our own immune system. Here is a look back at the top five research developments of 2017 at Moffitt Cancer Center.

1. CAR T Therapy Tested, Commercially Available at Moffitt

2. Novel Combination Approach to Lung Cancer Wins Moffitt a Stand Up To Cancer Grant

3. New Targets for Existing Cancer-Fighting Drugs

4. Less is More: Adaptive Therapy

One of oncology’s enduring dilemmas is cancer’s ability to develop resistance to chemotherapeutic drugs. What had once been effective seemingly loses its ability to kill cancer cells. Moffitt researchers have proposed rethinking drug resistance with a strategy called adaptive therapy that links the frequency, dosage and type of chemo to the tumor’s response. Based on evolutionary principles and tested through mathematical models, this strategy uses short bursts of therapy to suppress cancer growth rather than large doses of a therapeutic agent aimed at killing all of a patient’s cancer cells.

Now, Moffitt has used the adaptive therapy strategy to treat patients with metastatic prostate cancer. The results, published Nov. 28 in Nature Communications, show 10 of 11 men treated with abiraterone for advanced prostate cancer using an adaptive therapy strategy are approaching the two-year mark without evidence of disease progression. Their experience meets historical benchmarks that led to the drug’s FDA approval while cutting the amount of drug used in half - significant since its average wholesale price is $9,000 per month.

According to Robert Gatenby, M.D., study senior author and co-leader of the Cancer Biology & Evolution Program at Moffitt, "there is a natural tendency to use high-dose therapy based on the assumption that each patient receives maximum benefit by killing as many cancer cells as possible. However, according to evolutionary principles, high-dose therapy is the least likely to be successful in controlling the tumor for any length of time because it intensely selects for resistant cells and allows them to grow rapidly because the treatment has eliminated all of their competitors. We want to try to work with evolution rather than letting evolution be a source of our defeat." Read more here.

5. New Hope for Aggressive Leukemia