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Mathematical model predicts patient outcomes to adaptive therapy

Micrograph showing prostatic acinar adenocarcinoma (the most common form of prostate cancer) Credit: Wikipedia

Prostate cancer is the most common malignancy among men in the United States. It is also the second most common cause of cancer-related deaths. Despite improved treatments for prostate cancer, many patients with advanced disease eventually develop drug resistance. Researchers in the Center of Excellence for Evolutionary Therapy at Moffitt Cancer Center believe that adaptive treatments based on evolutionary principles may be an effective approach to prostate cancer treatment by preventing the development of drug resistance and prolonging patient survival.

In an article published today in Nature Communications, the research team provides a closer look at a model and data showing that individual patient alterations in the (PSA) biomarker early in treatment can predict outcomes to later treatment cycles of adaptive . These models could eventually be used to devise patient specific treatments according to changing tumor growth and biomarker patterns.

Patients with cancer are commonly treated with radiation therapy or surgery followed by androgen deprivation therapy (ADT) at the highest tolerated dose to kill as many cancer cells as possible. While initial responses to this approach are often effective, eventually patients develop and their tumors recur.

“Continuous treatment, by maximally selecting for resistant phenotypes and eliminating other competing populations, may actually accelerate the emergence of resistant populations—a well-studied evolutionary phenomenon termed competitive release,” said study author Heiko Enderling, Ph.D., associate member of Moffitt’s Department of Integrated Mathematical Oncology.

Enderling and his team, in collaboration with scientists from Duke University, University of North Carolina and Arizona State University, believe that instead of using a continuous maximum tolerated dose, a better approach would be to use adaptive therapy with intermittent dosing. This treatment strategy is based on changing patterns of

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Diabetes: What you need to know

More than 30 million Americans have diabetes, a disease that causes high blood sugar.

Normally, your body produces insulin, a hormone that helps regulate blood sugar levels. With diabetes, your body either can’t produce enough insulin or can’t properly use the insulin it does produce. This causes sugar to build up in the blood, which at high enough levels can damage nerves, eyes, kidneys, and other organs.

Here’s what you need to know:

Age, weight, race and ethnicity, and health problems can affect your risk of developing type 2 diabetes

If you’re age 45 or older, have a family history of diabetes, or are overweight, your risk of developing type 2 diabetes is higher. Physical inactivity, race, and certain health problems also can increase your risk. There is also a greater risk among certain races and ethnicities; for example, those of African American, Latino, Native American, and Pacific American descent. Make sure to contact your doctor or health care provider regarding screening to help.

Prediabetes is a warning sign

Prediabetes occurs when your blood sugar level is higher than normal, but not high enough to be type 2 diabetes. About 88 million American adults have this condition, and it can lead to type 2 diabetes. But you can do a lot to reduce your chances of developing the disease by losing weight and keeping it off. Staying physically active—for at least 30 minutes a day, five days a week—can also help. So can eating a healthier diet with less fat and calories.

Diabetes, if not controlled, can lead to health problems

If high blood sugar is left uncontrolled for too long, diabetes can lead to serious health problems. These include heart disease, stroke, kidney disease, eye problems, dental disease, nerve damage, and foot problems.

There are different types of diabetes