New study views cancer treatment as a game to find strategies that improve patient outcomes
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TAMPA, Fla. – Game theory can be utilized to identify potential flaws in current cancer treatment approaches and suggest new strategies to improve outcomes in patients with metastatic cancer, according to a new article published online today by JAMA Oncology. The study, which is authored by a mathematician, an evolutionary biologist and clinical physicians from Moffitt Cancer Center and Maastricht University, challenges the decades old standard of treatment for metastatic cancers in which drugs are typically administered continuously at the maximum-tolerated dose (MTD) until the tumor progresses.

The study shows that, by viewing cancer therapy as a game between the treating physician and the cancer cells, continuous administration of the same drug or drugs at MTD fails to exploit critical advantages possessed by the physician. Instead, the authors encourage oncologists to develop flexible strategic treatment plans. By exploiting his/her knowledge of the cancer’s evolutionary dynamics, the oncologist can continuously adjust drugs and doses to delay or prevent cancer progression caused by the evolution of resistance. With each adjustment, the oncologist updates information on the cancer’s response.

The Moffitt research team, led by Robert A. Gatenby, M.D., used mathematical modeling to investigate cancer treatment as a game played by the

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