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Printable Handouts
Navigable Slide Index
- Introduction
- Background
- Moffitt strategy
- Personalized oncology focuses on matching treatment to molecular targets
- General principles
- Second principle
- Combining personalized medicine and game theory models
- Adaptive therapy
- First clinical application
- Evolution-based mathematical models to design trial
- Integrating adaptive therapy mathematical model into clinical oncology practice (1)
- Integrating adaptive therapy mathematical model into clinical oncology practice (2)
- Current status
- Analyzing results using the underlying math model
- PSA dynamics pretreatment and during therapy
- Example
- Estimated patient control (1)
- Estimated patient control (2)
- Four patients in adaptive cohort remain on stably on treatment after >5 years
- Conclusions for this part
- Now, descent into pure speculation
- Has the magic bullet concept outlived its usefulness?
- Back to the drawing board
- Can cancer be cured?
- Intentional anthropogenic extinction: the Galapagos goat
- Hypothesis: first strike-second strike model for cancer cure
- First strike-second strike approaches yield highly variable dynamics
- Lessons for clinical therapy (1)
- Lessons for clinical therapy (2)
- Thank you
Topics Covered
- The molecular machinery of cancer resistance
- Adaptive therapy: exploiting the cost of resistance in cancer treatment
- Evolution-based mathematical models to design trial
- Integrating adaptive therapy mathematical model into oncology
- First strike-second strike model for cancer cure
Links
Series:
Categories:
Therapeutic Areas:
Talk Citation
Gatenby, B. (2022, October 31). Evolutionary dynamics in cancer control and cure [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved December 22, 2024, from https://doi.org/10.69645/BGZG1759.Export Citation (RIS)
Publication History
Financial Disclosures
- Dr. Bob Gatenby has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
A selection of talks on Clinical Practice
Transcript
Please wait while the transcript is being prepared...
0:00
Hi, my name is Bob Gatenby.
I'm a physician-scientist at
the Moffitt Cancer Center.
I'm a member of the Department
of Integrated
Mathematical Biology
and the Department of Radiology.
My topic is on the
evolutionary dynamics
in cancer control and cure.
0:19
I want to start with
some background.
The first is that cancer is
a complex dynamic system.
It's complex because
it has many components
and dynamic because
those components
interact with each other
often producing
non-linear dynamics.
To put that in perspective,
human intuition is very
good at linear dynamics.
If 1x = 2y and 2x = 4y, 3x = 6y,
we are very good at
predicting that.
However, if 1x = 2y and 2x = -5y
and 3x gives us 12y,
those are non-linear
dynamics and
human intuition is not very
good in dealing with that.
I think this is obvious
in what is the most
complex dynamic system
that's well known,
and that is the weather.
Just as an anecdote, I want
to tell a little story about
Benjamin Franklin
who was actually
a very outstanding scientist
in colonial America.
He wanted to see
a lunar eclipse.
When he was living
in Philadelphia,
he went out to see it.
But he was interrupted
by a violent storm,
in the US these are
called Nor'easters
because the wind comes
from the northeast.
Like all scientists of his day,
Franklin thought that the
wind carried the storm.
Therefore, since the wind
was coming out of the Northeast,
it would be coming from Boston.
Therefore, his brother
who lived in Boston,
would also not be able to
see the lunar eclipse.
He was shocked the next day
to learn that the storm
did not arrive in Boston until
after the eclipse was over.
Franklin was the first person
to really question this dogma,
that the wind carried the storm.
Now, this idea that wind carried
the storm is very linear.
If you ask a child,
they'll say that
because it makes sense.
But he was the
first to recognize
that this is a linear thinking,
but it's applied to a
complex dynamic system.
In fact, he very
astutely began to learn
that weather storms follow
variations in the
barometric pressure.
It's important to
recognize when we're
thinking about cancer
and cancer therapy,
that it is a non-linear system.
For that reason,
sometimes things that
are intuitively obvious
are also completely wrong.
We have to be able
to accept that.