Talks & activities
Cancer Therapy: Changing the Game
Activity: Talk or presentation (speaker at event) › Talk or presentation › Academic
22 Nov 2018
In this talk, we will investigate cancer treatment as a game-theoretic contest between the physician's therapy and the cancer cells' resistance strategies. This game has two critical asymmetries: (1) Only the physician can play rationally. Cancer cells, like all evolving organisms, can only adapt to current conditions; they can neither anticipate nor evolve adaptations for treatments that the physician has not yet applied. (2) It has a distinctive leader-follower (or "Stackelberg") dynamics; the "leader" oncologist plays first and the "follower" cancer cells then respond and adapt to therapy. Current treatment protocols for metastatic cancer typically exploit neither asymmetry. By repeatedly administering the same drug(s) until disease progression, the physician "plays" a fixed strategy even as the opposing cancer cells continuously evolve successful adaptive responses. By changing treatment only when the tumor progresses, treatment failure becomes nearly inevitable.
Using game theory, we will see how physicians can exploit the advantages inherent in the asymmetries of the cancer treatment game, and likely improve outcomes, by adopting more dynamic treatment protocols that integrate eco-evolutionary dynamics and modulate therapy accordingly. Implementing this approach will require new metrics of tumor response that incorporate both ecological (i.e. size) and evolutionary (i.e. molecular mechanisms of resistance and relative size of resistant population) changes.