基于达尔文演化动力学的适应性治疗策略在肿瘤治疗中的研究进展

Research progress of adaptive therapy strategy based on Darwinian dynamics in tumor therapy

辅助化疗药物和靶向治疗药物的应用极大地改善了晚期癌症患者的预后,但很快出现的耐药问题以及随之而来的病情迅速进展一直是癌症治疗领域的痛点。揉合了达尔文演化动力学的肿瘤适应性治疗(adaptive therapy,AT)是有别于传统最大耐受剂量(maximum tolerated dose,MTD)的新颖治疗理念,有望颠覆晚期癌症的治疗范式,实现患者长期的低负荷带瘤生存。本文对适应性治疗理论研究进展以及数学模型在优化适应性治疗策略中的重要地位进行综述,并对基于达尔文演化动力学的其他肿瘤治疗策略予以简述,以期为临床医师提供新的思路。

The applications of adjuvant chemotherapy and targeted drugs have greatly improved the prognosis of patients with advanced cancer,however the rapid emergence of drug resistance and the subsequent rapid progress of the disease have always been the unmet challenges in the field of cancer treatment.Adaptive therapy(AT)combined with Darwinian evolutionary dynamics is a new treatment concept different from the traditional maximum tolerated dose(MTD),which is expected to overturn the treatment paradigm of advanced cancer and achieve long-term low load tumor bearing survival.This paper reviewed the theory of AT and the important role of mathematical models in optimizing adaptive treatment strategies,then briefly described other tumor treatment strategies based on Darwinian dynamics,in order to provide new ideas for clinicians in the game with advanced cancer.