Created by: Maximilian Strobl, Jill Gallaher, Sandy Anderson, Jeffrey West

Issue 208: Adaptive therapy aims to leverage competition between drug-sensitive and resistant cells by adjusting treatment to maintain the tumor at a tolerable size, whilst preserving sensitive cells. This approach is being tested in trials but is not yet widely used as deeper understanding of cell-cell competition is required. In our recent paper, we used an agent-based model (written in HAL) to investigate how strongly, and with whom, resistant cells compete during continuous and adaptive therapy. This artwork combines snapshots from simulations of adaptive therapy under different parameterisations (varying rates of resistance costs and turnover) with a Muller plot (created using EvoFreq) illustrating the average neighbourhood composition around a resistant cells. Our work shows that the tumour’s spatial architecture is an important factor in adaptive therapy and provides insights into how adaptive therapy leverages both inter- and intra-specific competition to control resistance.