Gatenby Robert A, Vincent Thomas L
Department of Radiology, University of Arizona, Tucson, AZ 85724, USA.
Mol Cancer Ther. 2003 Sep;2(9):919-27.
Quantitative models from population biology and evolutionary game theory frame the tumor-host interface as a dynamical microenvironment of competing tumor and normal populations. Through this approach, critical parameters that control the outcome of this competition are identified and the conditions necessary for formation of an invasive cancer are defined. Perturbations in these key parameters that destabilize the cancer solution of the state equations and produce tumor regression can be predicted. The mathematical models demonstrate significant theoretical limitations in therapies based solely on cytotoxic drugs. Because these approaches do not alter critical parameters controlling system dynamics, the tumor population growth term will remain positive as long as any individual cells are present so that the tumor will invariably recur unless all proliferative cells are killed. The models demonstrate that such total effectiveness is rendered unlikely by the genotypic heterogeneity of tumor populations (and, therefore, the variability of their response to such drugs) and the ability of tumor cells to adapt to these proliferation constraints by evolving resistant phenotypes. The mathematical models support therapeutic strategies that simultaneously alter several of the key parameters in the state equations. Furthermore, the models demonstrate that administration of cytotoxic therapies will, by reducing the tumor population density, create system dynamics more conducive to perturbations by biological modifiers.
来自群体生物学和进化博弈论的定量模型将肿瘤-宿主界面构建为肿瘤与正常群体相互竞争的动态微环境。通过这种方法,确定了控制这种竞争结果的关键参数,并定义了侵袭性癌症形成所需的条件。可以预测这些关键参数的扰动,这些扰动会破坏状态方程的癌症解并导致肿瘤消退。数学模型表明,仅基于细胞毒性药物的疗法存在重大理论局限性。因为这些方法不会改变控制系统动态的关键参数,只要有任何单个细胞存在,肿瘤群体生长项就会保持为正,所以除非所有增殖细胞都被杀死,肿瘤必然会复发。模型表明,肿瘤群体的基因型异质性(以及因此它们对这类药物反应的变异性)以及肿瘤细胞通过进化抗性表型来适应这些增殖限制的能力,使得这种完全有效性不太可能实现。数学模型支持同时改变状态方程中几个关键参数的治疗策略。此外,模型表明,细胞毒性疗法的施用将通过降低肿瘤群体密度,创造出更有利于生物修饰剂产生扰动的系统动态。