“Kick It Whereas It’s Down” Cancer Treatment Strategy Shows Promise in Early Trials

A new study suggests that initiating a second cancer treatment while a tumor is still responding to the first—a strategy researchers call “kick it while it’s down”—could significantly improve cure rates. The research, published in Genetics, challenges the conventional “wait and spot” approach and offers a potential pathway to overcome treatment resistance.

The Problem of Cancer Relapse

Despite initial success with cancer therapies, tumors often relapse due to the emergence of drug-resistant mutations in cancer cells. The standard clinical practice is to monitor for regrowth and then introduce a different treatment. However, by this point, some cancer cells have likely already developed resistance to the second-line therapy, diminishing its effectiveness.

Evolutionary Theory and Cancer Treatment

Dr. Robert Noble, Senior Lecturer at the Department of Mathematics, City, St George’s, University of London, led the study. He explains that evolutionary theory suggests a more proactive approach. “Instead of waiting, it might be better to switch to a second treatment while the tumor is still responding to the first one,” he stated. ecancer.org

This strategy is particularly relevant when doctors anticipate that even the most effective initial treatment will eventually fail due to resistance. Dr. Noble draws parallels to successful evolutionary approaches in other fields, such as combating antibiotic resistance and predicting influenza vaccine strains. ecancer.org

Mathematical Modeling of Tumor Evolution

To test this hypothesis, Dr. Noble and his team utilized mathematical models traditionally used to study the evolution of plants and animals in response to environmental changes. ecancer.org These models allowed them to simulate tumor behavior and predict the outcomes of different treatment strategies.

Dr. Noble leads a mathematical oncology group at City St George’s, University of London, focusing on understanding cancer evolution through data-driven models. robjohnnoble.github.io

Clinical Trials Underway

The study’s findings support further clinical investigation. Currently, three modest clinical trials are underway, evaluating this “kick it while it’s down” approach in patients with soft-tissue cancer, prostate cancer, and breast cancer. Additional trials are in development.

“Our models predict that this new approach will, outperform standard treatment,” Dr. Noble explained. ecancer.org He added that while a sequence of two treatments may be effective for smaller tumors, alternating between three or more treatments could potentially eliminate larger tumors.

Looking Ahead

This research offers a promising new direction in cancer treatment, emphasizing the importance of proactively addressing treatment resistance. While further research and larger clinical trials are needed, the “kick it while it’s down” strategy represents a significant step towards improving outcomes for cancer patients.