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：

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癌症耐药性管理：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了耐药细胞。害虫管理者面临着类似的挑战，即选择具有抗药性的昆虫，从而产生类似的抗性机制。害虫管理者制定了十项原则，可以转化为控制癌症：（1）预防发病，（2）持续监测，（3）确定阈值，低于该阈值将不进行干预，（4）根据负担改变干预措施，（ 5）优先选择非化学防治方法，（6）使用靶向药物，（7）使用最低有效剂量，（8）减少交叉耐药性，（9）基于长期管理评估成功，（ 10）预测增长和反应。这些原则适用于所有癌症和抗癌药物，因此可以广泛应用于改善肿瘤学。在这里，我们回顾了控制害虫和癌细胞耐药性的并行困难。我们展示了害虫抗性管理原理如何应用于癌症。害虫综合防治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率和生活质量。这些害虫管理原则有可能为临床试验设计提供信息。