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Cancer algorithm uses game theory to double survival time

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nomads

On 7 March New Scientist reported about a novel approach on how to use standard hormone treatment. Perhaps worth of consideration in Australia too.

 

"Using algorithms to monitor cancer evolution and apply game theory to their treatment has doubled the survival time of men with advanced prostate cancer" 

 

..."It typically takes prostate cancers 15 months to evolve resistance to standard doses of abiraterone, at which point the tumours are able to grow bigger than their initial size. But in an ongoing trial of the algorithm in the treatment of 17 men, this timescale has more than doubled to an average of 33 months – and could keep rising. Cancer has been able to progress in only three men in the trial, and some of the participants have now lived for four years without this happening, Gatenby told New Scientist. These results are so impressive that the team is beginning a larger trial"... https://www.newscientist.com/article/mg23731682-600-cancer-algorithm-uses-game-theory-to-double-survival-time/

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Colin Glover

This is very exciting news, for me. I wonder how one could get on a trial or find somebody who has intimate knowledge of game theory. 

The New Scientist has a pay wall. However if you go to the Coffs Coast you'll get a lengthy summary.   https://coffscoastoutlook.com.au/cancer-algorithm-uses-game-theory-to-double-survival-time/

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Johnno

It is exciting news , however I wish treating oncologist would adopt this approach during every stage of the disease and not " one size fits all " and  "boots and all" theory. To me it makes sense and the idea that we have to wait until we become resistance to a particular drug which in turn creates a mutant cancer seems very primative.

I am about to finish my 4th cycle of docitaxel before moving on to aberaterone so I may be looking for an oncologist willing to use available data from trials like this one. 

Thanks for the post - positive waves...

 

 

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Colin Glover

I'm with you Johnno although I'm still on Lucrin I don't think I should have to wait till it fails before finding something else. If I can avoid radiation that will be a big plus.

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Admin

Jim Marshall (not a doctor) said ...

You or your oncologist do not have to know game theory to understand the strategy.

Game theory is only used to show that, if the model of cancer progression the authors have used is correct, short sessions of abiraterone repeated regularly should give better control than starting with a big session.

 

The rule they used to make repeated short sessions was very simple.

First Measure PSA now. Call that base PSA

1. Use abiraterone until the PSA becomes half of base PSA.

2. Stop abiraterone until the PSA becomes equal to base PSA.

Repeat 1 and 2.

 

Your oncologist will be keen to see what happens in later trials of this, with sufficient numbers to make sensible decisions.

With just 11 patients in this report, and the chance that the small numbers, and monthly attention from their doctors, there is a good chance that this may be an unrealistic result. Your oncologist will probably prefer to stick with treatments that have already been proven.

... end Jim

 

 

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nomads

There's certainly no doubt that "your oncologist will probably prefer to stick with treatments that have already been proven." The question just is - and that has been the focus in this small trial - if this couldn't be a better strategy for overall survival and quality of life. I would have definitely preferred a chance to participate in such a trial  and perhaps extending Enzalutamide efficacy beyond the 10 months it worked.

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Admin

Jim Marshall (not a doctor) said ...

Zhang in the report we are talking about refers to a study by Crook, summarising the results for intermittent ADT vs continuous ADT after recurrence thus:

Quote

After a median follow up of 9.8 years, neither regimen proved superior.

However, if you are a man with Gleason score of 8, 9 or 10, your doctor may take note of Crook's results with these high-risk men.

I reported on that in a topic called Had radiation, or surgery then radiation, but my PSA has started rising – intermittent ADT or continuous ADT? here:

... end Jim

 

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