Adaptive therapy

Adaptive therapy is a treatment strategy that adjusts drug dosing to maintain a tumor population rather than eradicate it, keeping drug-sensitive cells alive to suppress resistant ones.

The strategy

Standard maximum-tolerance dosing applies the strongest possible selection for resistant cells and removes the sensitive competitors that held them in check. Robert Gatenby and colleagues inverted this: dose to control tumor burden, not to eliminate it, and change the dose as the measured tumor burden changes. When the tumor shrinks, treatment eases; when it grows, treatment resumes. The goal is a stable tumor composed mostly of sensitive cells, with resistant clones held down by