Why Is Evolution Important in Cancer and What Mathematics Should Be Used to Treat Cancer? Focus on Drug Resistance
Résumé
The clinical question of drug resistance in cancer, our initial motivation to study
continuous models of adaptive cell population dynamics, leads naturally and more
generally to consider the cancer disease itself from an evolutionary biology view-
point, a consideration without which even the best targeted therapies will likely
most often eventually fail. Among the challenging questions to mathematicians
who tackle the task of understanding this disease and optimising its treatment
are the representation of phenotypic heterogeneity of cancer cell populations and
of their plasticity in response to anticancer drug insults. Such representation can
be obtained using phenotype-structured models of healthy and cancer cell popula-
tions, and optimal control methods to optimise drug effects, with the perspective
to implement them in the therapeutics of cancer, aiming at both avoiding the
emergence of drug resistance in tumours and taking into account a constraint of
limiting unwanted adverse effects to healthy tissues.
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