# Integrating evolutionary dynamics into treatment of metastatic castrate-resistant prostate cancer

Source: https://onco.cc/key-papers/paper-zhang-nat-commun/  
OnCo record `paper-zhang-nat-commun` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Paper cited by one technology page, one pathway page and one term page, indexed on Europe PMC as PubMed record 29180633 and published in Nature Communications; the citing pages link this DOI, which is how the record was matched.

## Summary

Abiraterone treats metastatic castrate-resistant prostate cancer by inhibiting CYP17A, an enzyme for testosterone auto-production. With standard dosing, evolution of resistance with treatment failure (radiographic progression) occurs at a median of ~16.5 months. We hypothesize time to progression (TTP) could be increased by integrating evolutionary dynamics into therapy. We developed an evolutionary game theory model using Lotka-Volterra equations with three competing cancer "species": androgen dependent, androgen producing, and androgen independent. Simulations with standard abiraterone dosing demonstrate strong selection for androgen-independent cells and rapid treatment failure. Adaptive therapy, using patient-specific tumor dynamics to inform on/off treatment cycles, suppresses proliferation of androgen-independent cells and lowers cumulative drug dose. In a pilot clinical trial, 10 of 11 patients maintained stable oscillations of tumor burdens; median TTP is at least 27 months with reduced cumulative drug use of 47% of standard dosing. The outcomes show significant improvement over published studies and a contemporaneous population.

Indexed on Europe PMC as PubMed record 29180633 (DOI 10.1038/s41467-017-01968-5). Matched by DOI alone: one technology page, one pathway page and one term page cite this DOI among their external links (the pages are listed under Related), and this page was written so that the citation resolves inside OnCo. No figure has been checked by an editor.

## Fields

- Kind: Key paper
- Last checked: 2026-09-22
- Tags: europepmc-ingest
- Journal: Nature Communications
- Year: 2017
- DOI: 10.1038/s41467-017-01968-5
- Authors: Zhang J, Cunningham JJ, Brown JS, et al.
- What it means: One technology page, one pathway page and one term page on OnCo cite this paper by its DOI; this record gives the citation a page of its own so a reader can follow it without leaving OnCo. Read the abstract above alongside the citing pages listed under Related; the record was created automatically from the Europe PMC entry and its figures have not been checked by hand.
- Caveats: Matched to the citing OnCo records by DOI alone; the summary reproduces the Europe PMC abstract and no figure has been verified against the full paper.

## Sources

- Nat Commun 2017: https://doi.org/10.1038/s41467-017-01968-5
- PubMed: https://pubmed.ncbi.nlm.nih.gov/29180633/
- Europe PMC: https://europepmc.org/article/MED/29180633

## Connected records

- technologies: [Adaptive therapy (evolution-based dosing)](https://onco.cc/technologies/adaptive-therapy-dynamics/)
- pathways: [Clonal evolution & minimal residual disease](https://onco.cc/pathways/clonal-evolution/)
- terms: [Clonal evolution and the ecological view of cancer](https://onco.cc/terms/clonal-evolution-theory/)
- journals: [Nature Communications](https://onco.cc/journals/nature-communications/)

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