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Jill Galagher : Targeting the phenotype: Treatment strategies for heterogeneous cancer

Targeted cancer drugs attack pathway specific phenotypes and can lead to very positive outcomes when a particular phenotype dominates the population of a specific tumor. However, these drugs often fail because not all cells express the targeted phenotype to the same degree. This leads to a heterogeneous response to treatment, and ultimate recurrence of the cancer as sensitive cells die off and resistant cells take over. We explore how treatment strategies informed by a tumor’s phenotypic mix, can help slow the emergence of resistance and stave off tumor recurrence. We use an off-lattice agent-based model that incorporates inheritance of two phenotypes – proliferation rate and migration speed – and is modulated by a space limiting selection force. We find how and when distinct distributions of phenotypes require different treatment strategies.

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