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Access through your institution Buy or subscribe Analysis of a mathematical model of an evolution-based strategy for two-drug therapy has shown it could improve outcomes in men with
metastatic castration-resistant prostate cancer (mCRPC). In this study, the authors developed an evolution-based approach in which therapies are divided into primary and secondary roles,
termed primary–secondary therapy. In this approach, the drug that has the highest efficacy and/or the lowest toxic effects is the primary therapy. The only role of the secondary drug is to
reduce the population of cells resistant to the primary drug. Specifically, the investigators considered the context of a clinical trial of treatment of mCRPC in which the administration of
abiraterone was dependent on patient response and informed by an evolution-based mathematical model. The addition of docetaxel was investigated to reduce proliferation of
androgen-independent, abiraterone-resistant cells. Thus, the primary–secondary strategy in this context comprised abiraterone as the primary drug and docetaxel as the secondary therapy.
Using this context, the authors quantitatively investigated the hypothesized evolutionary dynamics of this strategy using mathematical modelling. This is a preview of subscription content,
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institutional subscriptions * Read our FAQs * Contact customer support REFERENCES ORIGINAL ARTICLE * West, J. B. et al. Multidrug cancer therapy in metastatic castrate-resistant prostate
cancer: an evolution-based strategy. _Clin. Cancer Res._ https://doi.org/10.1158/1078-0432.CCR-19-0006 (2019) Article PubMed Google Scholar Download references AUTHOR INFORMATION AUTHORS
AND AFFILIATIONS * Nature Reviews Urology http://www.nature.com/nrurol/ Louise Stone Authors * Louise Stone View author publications You can also search for this author inPubMed Google
Scholar CORRESPONDING AUTHOR Correspondence to Louise Stone. RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Stone, L. An adaptive approach to therapy.
_Nat Rev Urol_ 16, 388 (2019). https://doi.org/10.1038/s41585-019-0197-z Download citation * Published: 20 May 2019 * Issue Date: July 2019 * DOI: https://doi.org/10.1038/s41585-019-0197-z
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