October 02, 2017

Applying Evolutionary Biology to Make Progress in Cancer Medicine

William Audeh , Cedars-Sinai Medical Center

Principles of Evolutionary Biology have been applied to the problem of cancer, primarily to explain why cancer develops. This approach has focused on intrinsic mutation rates and the stochastic risk of carcinogenesis, as well as the issue of "mismatch", in which the argument is made that cancer arises because the human genome is mismatched and maladapted to the modern environment. What has been lacking until recently, however, is the practical application of evolutionary biology to guide the therapy of cancer in a clinically meaningful way. Cancer is understood and managed by clinicians as a clinical disease, rather than what evolutionary biology more correctly identifies it to be: a diverse population of cells undergoing active micro-evolution, adapting in response to the selective pressures of therapy and the tissue micro-environment, like an invasive species. The explosion of genomic information about cancer now allows a different, biologically-enlightened strategy to guide cancer therapy, based upon recognized principles of evolutionary biology and population genetics. This is very similar in topic to the talk I gave at Grand Rounds for Darwinian Medicine Month in February, but will be modified and updated for a non-clinical audience.