Summary
The Drive podcast features a conversation between the host, Peter Etia, and a guest named Bob, who discusses the challenges of modeling complex systems, such as cancer biology, and the importance of using mathematics and computer simulations to understand them. The conversation touches on the arrogance of some physicians who believe they can master complex systems without the use of models. The discussion also explores the use of predator-prey models to understand the dynamics of ecosystems and how they can be applied to cancer biology. The conversation emphasizes the need for humility when dealing with complex systems and the importance of recognizing the limitations of models.
The context discusses a pilot trial of intermittent therapy for patients with metastatic prostate cancer. The trial aimed to use the sensitive cells to control the resistant cells and drive the resistant population to extinction. The conversation then shifts to the use of antibiotics and bacteria, and how the standard practice of giving antibiotics for a set amount of time may not be the best approach as it could lead to antibiotic resistance. The conversation also touches on the issue of cancer cells and how they differ from bacteria, as well as the heterogeneity and vulnerability of tumors. The conversation concludes with a discussion on how pediatric oncologists have learned to use different therapies to treat leukemia and how it may be a more effective approach to treating cancer in general.
The context is a conversation about cancer and how it spreads. The speaker uses an analogy of a society to explain how a decimated population would be more susceptible to attack. They discuss how tumors after neoadjuvant therapy are small and widely separated, making them vulnerable to immune-based therapies like immunotherapy. The conversation then shifts to the source/sync trade-off in cancer, where some cancers can kill without spreading while others always leave and spread to other tissues. The speaker notes that this is not a planned event, but rather an evolving population adapting to conditions.
In this podcast, the speakers discuss the basic rules that cancer cells follow when metastasizing to different parts of the body. They explain that the pancreas tends to metastasize to the liver because it sends a lot of cells there through the portal vein. They also talk about the importance of considering eco-evolutionary dynamics in cancer treatment, rather than simply administering a single drug continuously. They argue that the genetics of tumors are more complicated than simply being a disease of the genes, and that understanding the morphology of the cell and its environment is crucial in understanding cancer.
The speaker discusses the process of cancer cells speciation and how it is influenced by environmental variations. They also talk about the limitations of studying cancer cells in vitro and the confusion it can cause in the literature. The speaker suggests using imaging to understand internal evolution over time and mentions the possibility of combining different tools to better understand inter-terminal evolution during therapy. The podcast ends with a discussion about the difficulty of finding an oncologist willing to try new therapies and the medical legal issues that arise when doing so.
