Original | Adaptive therapy: a new strategy for tumor therapy

Drug source analysis Traditional tumor therapy to maximize the killing of tumor cells as the goal of treatment, as long as the patient's body can withstand the doctor as far as possible with the maximum dose of drugs to reduce the patient's tumor as soon as possible, so the chemotherapy dose is close to MTD.
because tumor volume changes are easy to observe so patients, doctors can visually see the effects of drugs, early clinical also often to tumor shrinking as the main indicator.
even if a new therapy does not improve survival, prolonging so-called non-progressive survival is sometimes considered a valuable treatment, as it is generally assumed that no progression of the tumor is beneficial to the quality of life of the patient.
But in many tumors, such as common lung cancer treatment, tumor shrinking and stopping growth time is not significantly related to patient survival, to some extent questioning the treatment strategy aimed at rapidly killing tumor cells.
implicit assumption of this strategy is that the tumor is a relatively single group of people, and it doesn't matter who's left.
the fact that the tumor is a highly ordered organization, just as special forces continue to optimize their combat effectiveness through final phase-out.
Although escaping apoptosis is considered to be one of the core characteristics of tumors, the apoptosis system of many tumors is more active than normal tissue, but replication is also faster so the net result is out of control growth, some often induced apoptosis promotes tumor occurrence.
cells release substances before they die to stimulate the regeneration of new cells and create a micro-environment more suited to tumor survival, a repair mechanism that uses many of the biological processes of wound healing, so tumors are also called wounds that never heal.
therefore the more cancer treatment is killed, the better, especially when the therapy is less selective.
tumor shrinking may not be able to reliably predict patients' survival time and quality of life.
that, with the exception of some blood tumors and a few solid tumors, the vast majority of tumors are resistant despite being drug-sensitive at first.
treatment of tumors becomes more complex after drug resistance, so first-line therapy largely determines the final treatment effect.
the story of the horse said that the thousand-horse and ordinary horse-cart breeding is no different, but also a huge amount of food, even to participate in the long-distance race also because of the usual not enough to eat the total withdrawal.
is similar to tumor tissue, and drug-sensitive tumor cells are usually lower-maintenance cells.
low cost is that the fight against drugs is poor, and if a tumor is full of these cells, it can be cured by the drug.
but now most solid tumors have drug-resistant clones in addition to sensitive cells, which are similar to thousands of miles.
Because of the need for higher cost of living, such as expressive drug pumps, increased DNA repair function, etc., there is no advantage in the absence of therapeutic stress, and because it is difficult to compete with simpler sensitive tumor cells and die between the troughs.
if sensitive tumor cells are removed by the drug, then the TME becomes the world of drug-resistant cells after the competitive pressure drops, and by definition the drug is no longer virable.
So it is now thought that retaining a certain level of sensitive tumor cells to limit the growth of drug-resistant cells may be a better strategy, not only to reduce the toxicity of the drug system, improve the quality of life of patients, but also to control tumors for longer periods of time, delaying the occurrence of out-of-control drug-resistant tumors.
The so-called adaptation therapy sees tumors as an evolutionary dynamic tissue that builds on the experience of controlling rather than simply eliminating pests in agriculture to maintain a sensitive group of tumor cells that compete with drug-resistant strains by adjusting drug doses.
of course this is also a technical job, because there is no basis for controlling what level is best, if no treatment is obviously sensitive to tumor cells the most, but will not save the patient's life.
if there is a new drug that can reliably control tumor development, it will be an interesting treatment strategy to control the tumor to the scale that neither kills the host nor leaves the drug-resistant strain without food.
of course, it would be better if there were a mechanism for inhibiting the growth of another type of more malignant tumor with metabolites from one type of tumor, similar to antibiotics.
As to why the tumor died to grow crazy, pressing the gourd to float is only a result of natural selection, only so highly heterogeneous, able to cope with a variety of severe tumor tissue eventually become a disease of social concern.
the wound healing tissue also has a short period of rapid growth, but because it can be stopped in time so it is not studied as a serious disease.
addition to recent immunotherapy, solid tumor therapy has a limited contribution to prolonging a patient's life.
and immunotherapy is not a direct killer, suggesting that the time has come to consider new treatment strategies.