Adaptive Therapy (AT) is a therapeutic strategy for preventing tumor resistance for as long as possible by modulating drug delivery in response to tumor size: stopping drug delivery once the tumor volume is below a certain size and starting drug delivery again once it reaches the volume it had when treatment began. This fluctuation prevents resistance by maintaining a sensitive tumor cell population that keeps the resistant population in check. AT has shown promise in the clinic; however, it may not meaningfully improve progression time in all cases. In this work, we investigated the circumstances under which AT is more successful than continuous therapy at treating a spatial full-tumor model with the surrounding vasculature and epithelium represented. We altered the density of the surrounding tissue, the angiogenesis and glucose consumption rates of the tumor, the cost of drug resistance on resistant cells, and the threshold for stopping drug delivery to see how AT performs under these conditions. We find that it is necessary that the resistant cells pay a movement cost in order for AT to be more successful than continuous therapy. The movement cost slows down the resistant cell growth and allows the sensitive cells to contain them spatially. We also find that the relative effectiveness of AT and the optimal threshold for stopping drug depends on the tumor phenotype and the density of the surrounding tissue. We hope that these properties can be determined in patients such that this work may help inform their candidacy for AT.
© 2026 - The Mathematical Oncology Blog
© 2026 - The Mathematical Oncology Blog