DOI: 10.1101/491829Dec 10, 2018Paper

Optimizing adaptive cancer therapy: dynamic programming and evolutionary game theory

BioRxiv : the Preprint Server for Biology
Mark GluzmanAlexander Vladimirsky


Recent clinical trials have shown that the adaptive drug therapy can be more efficient than a standard MTD-based policy in treatment of cancer patients. The adaptive therapy paradigm is not based on a preset schedule; instead, the doses are administered based on the current state of tumor. But the adaptive treatment policies examined so far have been largely ad hoc. In this paper we propose a method for systematically optimizing the rules of adaptive policies based on an Evolutionary Game Theory model of cancer dynamics. Given a set of treatment objectives, we use the framework of dynamic programming to find the optimal treatment strategies. In particular, we optimize the total drug usage and time to recovery by solving a Hamilton-Jacobi-Bellman equation based on a mathematical model of tumor evolution. We compare adaptive/optimal treatment strategy with MTD-based treatment policy. We show that optimal treatment strategies can dramatically decrease the total amount of drugs prescribed as well as increase the fraction of initial tumour states from which the recovery is possible. We also examine the optimization trade-offs between the total administered drugs and recovery time. The adaptive therapy combined with optimal control t...Continue Reading

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