Opinion: Control vs. eradication: Applying infectious disease treatment strategies to cancer
- Gunther Jansena,b,1,
- Robert Gatenbyc, and
- C. Athena Aktipisb,d,e
- aDepartment of Evolutionary Ecology and Genetics, University of Kiel, 24118 Kiel, Germany;
- bInstitute for Advanced Study, 14193 Berlin, Germany;
- cCancer Biology and Evolution Program, Moffitt Cancer Center, Tampa, FL 33612;
- dCenter for Evolution and Cancer, University of California, San Francisco, CA 94143; and
- ePsychology Department, Arizona State University, Tempe, AZ 85287
Clinical treatment for metastatic cancer has traditionally entailed administering the highest possible dose in the shortest period, a strategy known as high-dose density therapy. The implicit goal is complete eradication. Unfortunately, a systemic cure for most metastatic cancers remains elusive, and the role of chemotherapy has been reduced to prolonging life and ameliorating symptoms.
These three infectious disease-controlling strategies have the potential to be translated into cancer-control measures. They all avoid attempting to completely eradicate tumor cells, instead aiming to (i) limit essential resources to cancer cells, (ii) disrupt cooperation among cancer cells, and (iii) prevent host damage.
Recently, the application of evolutionary and ecological principles to cancer therapy and infectious disease treatment has led to a rethinking of conventional treatments. High dose-density therapies may in fact accelerate the emergence and growth of resistant cell populations in both cancer (1) and infectious disease (2, 3), leading many to question the approach of complete eradication on evolutionary grounds (4⇓⇓–7).
An alternative to the traditional approach is a control-based tactic that focuses on extending patient life and reducing suffering by limiting, rather than eradicating, the growth and spread of cancer. Although control-based approaches have been used in infectious disease, they have not …
↵1To whom correspondence should be addressed. Email: gjansen{at}zoologie.uni-kiel.de.
