Mathematical modeling of cyclic treatments of chronic myeloid leukemia

Natalia L. Komarova

doi:10.3934/mbe.2011.8.289

Article Contents

2011, Volume 8, Issue 2: 289-306. Doi: 10.3934/mbe.2011.8.289

This issue Previous Article Questions from the fourth son: A clinician reflects on immunomonitoring, surrogate markers and systems biology Next Article Optimal and suboptimal protocols for a mathematical model for tumor anti-angiogenesis in combination with chemotherapy

Mathematical modeling of cyclic treatments of chronic myeloid leukemia

Natalia L. Komarova^1,

1.
Department of Mathematics, University of California Irvine, Irvine CA 92697

Received: April 2010

Revised: August 2010

Published: March 2011

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Abstract

Cyclic treatment strategies in Chronic Myeloid Leukemia (CML) are characterized by alternating applications of two (or more) different drugs, given one at a time. One of the main causes for treatment failure in CML is the generation of drug resistance by mutations of cancerous cells. We use mathematical methods to develop general guidelines on optimal cyclic treatment scheduling, with the aim of minimizing the resistance generation. We define a condition on the drugs' potencies which allows for a relatively successful application of cyclic therapies. We find that the best strategy is to start with the stronger drug, but use longer cycle durations for the weaker drug. We further investigate the situation where a degree of cross-resistance is present, such that certain mutations cause cells to become resistant to both drugs simultaneously.

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Mathematics Subject Classification: Primary: 92C50; Secondary: 92D25, 60G35.

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