Despite the effectiveness of many cancer therapies in reducing tumor burden for significant amounts of time in a subset of patients, primary and acquired resistance to treatment remain one of the biggest challenges in the effort to cure cancer. Successful management, or prevention, of resistance requires deciphering the mechanisms by which it arises, and in particular whether it stems from pre-existing cell populations or arises de novo during therapy. Using evolutionary principles and mathematical techniques together with patient data, we aim to develop a precise mathematical understanding of the dynamics of response and resistance to various cancer therapies, including targeted therapies and immunotherapy. Our work shows that therapies that maximize the killing rate of cancer cells may not be optimal, and that instead the parameters determining the fraction of resistant cells and their growth rate have a larger effect on the long-term control of cancer.

Citation Format: Ivana Bozic. Dynamics of response and resistance to cancer therapy [abstract]. In: Proceedings of the AACR Special Conference on the Evolutionary Dynamics in Carcinogenesis and Response to Therapy; 2022 Mar 14-17. Philadelphia (PA): AACR; Cancer Res 2022;82(10 Suppl):Abstract nr IA020.