Adaptive Therapy of Metastatic Melanoma: Calibration and Prediction of A Mathematical Model.

Adaptive therapy seeks to use intra-tumoral competition to avoid or delay the emergence of drug resistance in cancer treatment. Driven by clinical trials of metastatic castrate-resistant prostate cancer, people are increasingly interested in extending this approach to other tumors. A mathematical model that includes two cell populations of sensitive cells and drug-resistant cells has been studied in this article. The data of patients with metastatic melanoma is calibrated and the outcome of adaptive therapy is predicted. Studies have shown that the progress time of adaptive therapy depends on the initial tumor density, initial resistance level, drug-induced drug resistance rate and baseline size of tumor treatment. For adaptive therapy to provide a benefit, the tumor burden must undergo a sufficient decline to allow for treatment withdrawal, competition within the tumor must be sufficiently strong and the rate of drug-induced resistance must be reduced as much as possible. Prolonging the tumor treatment holiday can enhance intra-tumoral competition and improve the effect of adaptive therapy. This work provides a practical and effective treatment for metastatic melanoma, and provides a possible idea for patients with melanoma to design adaptive treatment. This article is protected by copyright. All rights reserved.