Researchers are investigating how well-known strategies for managing agricultural pests could be modified to enhance cancer treatment. This innovative approach offers new opportunities to combat drug resistance and improve survival rates for patients.
Just as pests develop resistance to pesticides, cancer cells can evolve to resist treatments, increasing their aggression. The primary reason for cancer fatalities relates to the development of resistance to therapies.
In a recent review, researchers from Arizona State University, collaborating with global experts, examine how existing pest management strategies from agriculture may be applied to cancer therapy. This groundbreaking approach presents new ways to tackle drug resistance and enhance patient survival.
This research, published in the latest issue of the journal Cancer Research, assesses ten pest management principles that could be adapted to address cancer.
This strategy marks a significant shift in perspective, focusing on treating cancer as a chronic condition rather than aiming for complete elimination, particularly when a cure is not feasible. Physicians are beginning to implement these strategies, referred to as adaptive therapy.
By utilizing agricultural pest management concepts, a new path is opened in cancer research and treatment for a disease that claims nearly 10 million lives globally each year, according to the World Health Organization (WHO).
“We’ve approached cancer treatment as if the disease doesn’t adapt to our interventions. It’s time we take this evolution into account and guide it rather than let it dominate,” states Carlo Maley, co-corresponding author of the study.
Maley is a researcher at the Biodesign Center for Biocomputing, Security, and Society and teaches in the School of Life Sciences at ASU. He also leads the Arizona Cancer Evolution Center. The interdisciplinary team combines efforts from cancer researchers and pest management specialists.
A history of drug resistance
Research in the 1940s highlighted a major challenge in effective cancer treatment—resistant cells that survived existing therapies. This scenario parallels agricultural challenges faced by farmers in earlier decades when insects became resistant to pesticides, threatening crops.
Drug resistance is a significant reason for the failure of cancer treatments, arising when therapies inadvertently foster the survival of resistant cancer cells—similar to how pesticides can lead to resilient insect populations.
When resistance is selected, the cancer cells or insects with resistant traits survive and reproduce, while the others are eliminated. Over time, these resistant strains become dominant, complicating treatment effectiveness and management.
Agricultural techniques inspire improved cancer treatment
A collection of farming practices known as integrated pest management employs biological, chemical, and mechanical controls to sustainably manage pests. Researchers aspire to adapt ten key principles from these techniques to transform cancer treatment and research.
The principles involve:
- Prevention first: Enhancing patient care and modifying the environment to hinder cancer cell growth.
- Continuous monitoring: Utilizing advanced techniques like liquid biopsies to observe tumor progression and resistance indicators in real-time.
- Only treat when necessary: Establishing specific treatment thresholds to reduce unnecessary medication use.
- Adaptive treatment: Varying therapies and adjusting doses based on tumor reactions to sustain long-term management.
- Minimal impact: Choosing treatments that have lesser side effects and toxicity.
- Nonchemical approaches: Integrating strategies such as surgery and immunotherapy to decrease dependence on harmful drugs.
- Dose optimization: Administering the lowest effective doses to slow the emergence of resistance.
- Cross-resistance reduction: Avoiding repetitive use of medications with similar action mechanisms.
- Long-term success metrics: Prioritizing survival and quality of life over complete disease eradication.
- Forecasting outcomes: Employing predictive models to foresee tumor behavior and refine treatment strategies.
This proactive approach can tackle treatment resistance faced by current cancer therapies, whether single or multi-drug regimens.
Adaptive therapy is applicable to all cancer types, providing a broad framework for oncology advancement. For instance, colorectal cancer, which presents various treatment options yet poor outcomes in later stages, is an ideal candidate for clinical trials utilizing this method.
To unlock the full potential of this innovative approach, the researchers underscore the significance of personalized medicine. Continuous genomic profiling and liquid biopsies during treatment serve as valuable tools for customizing cancer therapies. By monitoring changes in tumor mutations and cancer biomarkers in bodily fluids, these methods help oncologists adapt treatments in real time and curb the development of drug-resistant cells while reducing toxic side effects.
Adaptive therapy in action
In a previous study—one of the first of its kind— Maley, primary author Sareh Seyedi, and their team employed adaptive therapy in a mouse model of a particularly resistant type of breast cancer.
Contrary to conventional cancer treatments aiming to eradicate as many cancer cells as possible through maximum doses, adaptive therapy uses lower or intermittent doses to control tumor growth. This method takes advantage of the competition between drug-sensitive and resistant cancer cells to enhance survival and mitigate treatment resistance.
The researchers found that by alternating or adjusting the doses of two anti-cancer drugs, they could significantly extend survival compared to traditional treatments. This method also resulted in lower total drug doses, decreasing toxicity while improving outcomes.
The researchers envision a future where adaptive therapy is a fundamental aspect of cancer treatment. Ongoing preclinical research aims to solidify these principles, followed by clinical trials to assess their effectiveness in patients with advanced cancer.
Alongside ASU colleagues, Maley collaborates with national and international researchers from institutions such as Mayo Clinic, University of Arizona, North Carolina State University, University of California Santa Barbara, The Institute of Cancer Research, The Royal Marsden Hospital, Research Casting International, Istanbul University, and University of Lausanne.
