One of the main reasons we have not been able to cure cancers is that treatments select for drug-resistant cells. Pest managers face similar challenges with pesticides selecting for pesticide-resistant insects, resulting in similar mechanisms of resistance. Pest managers have developed ten principles that could be translated to controlling cancers: (1) prevent onset, (2) monitor continuously, (3) identify thresholds below which there will be no intervention, (4) change interventions in response to burden, (5) preferentially select non-chemical control methods, (6) use target-specific drugs, (7) use the lowest effective dose, (8) reduce cross-resistance, (9) evaluate success based on long-term management, and (10) forecast growth and response. These principles are general to all cancers and cancer drugs and so could be employed broadly to improve oncology. Here, we review the parallel difficulties in controlling drug resistance in pests and cancer cells. We show how the principles of resistance management in pests might be applied to cancer. Integrated pest management inspired the development of adaptive therapy in oncology to increase progression-free survival and quality of life in patients with cancers where cures are unlikely. These pest management principles have the potential to inform clinical trial design.

中文翻译：

---

癌症的耐药性管理：农民的经验教训


我们无法治愈癌症的主要原因之一是治疗选择耐药细胞。害虫管理人员在选择杀虫剂抗性昆虫时面临着类似的挑战，从而导致类似的耐药机制。害虫管理者已经制定了十项原则，这些原则可以转化为控制癌症：（1） 预防发作，（2） 持续监测，（3） 确定阈值，低于该阈值将不会进行干预，（4） 根据负担改变干预措施，（5） 优先选择非化学控制方法，（6） 使用目标特异性药物，（7） 使用最低有效剂量，（8） 减少交叉耐药性，（9） 根据长期管理评估成功， （10） 预测增长和响应。这些原则适用于所有癌症和癌症药物，因此可以广泛用于改善肿瘤学。在这里，我们回顾了控制害虫和癌细胞耐药性的平行困难。我们展示了如何将害虫的抗性管理原则应用于癌症。综合害虫管理激发了肿瘤学适应性疗法的发展，以提高不可能治愈的癌症患者的无进展生存期和生活质量。这些害虫管理原则有可能为临床试验设计提供信息。