natalia komarova (university of california - irvine) somatic evolution and cancer

146
Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Post on 21-Dec-2015

224 views

Category:

Documents


0 download

TRANSCRIPT

Page 1: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Natalia Komarova

(University of California - Irvine)

Somatic evolution and cancer

Page 2: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Plan• Introduction: The concept of somatic evolution• Methodology: Stochastic processes on

selection-mutation networks

Two particular problems:

1. Stem cells, initiation of cancer and optimal tissue architecture (with L.Wang and P.Cheng)

2. Drug therapy and generation of resistance: neutral evolution inside a tumor (with D.Wodarz)

Page 3: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Darwinian evolution (of species)

• Time-scale: hundreds of millions of years

• Organisms reproduce and die in an environment with shared resources

Page 4: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Darwinian evolution (of species)

• Time-scale: hundreds of millions of years

•Organisms reproduce and die in an environment with shared resources

• Inheritable germline mutations (variability)

• Selection (survival of the fittest)

Page 5: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Somatic evolution

• Cells reproduce and die inside an organ of one organism

• Time-scale: tens of years

Page 6: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Somatic evolution

• Cells reproduce and die inside an organ of one organism

• Time-scale: tens of years

• Inheritable mutations in cells’ genomes (variability)

• Selection (survival of the fittest)

Page 7: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Cancer as somatic evolution

• Cells in a multicellular organism have evolved to co-operate and perform their respective functions for the good of the whole organism

Page 8: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Cancer as somatic evolution

• Cells in a multicellular organism have evolved to co-operate and perform their respective functions for the good of the whole organism

• A mutant cell that “refuses” to co-operate may have a selective advantage

Page 9: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Cancer as somatic evolution

• Cells in a multicellular organism have evolved to co-operate and perform their respective functions for the good of the whole organism

• A mutant cell that “refuses” to co-operate may have a selective advantage

• The offspring of such a cell may spread

Page 10: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Cancer as somatic evolution

• Cells in a multicellular organism have evolved to co-operate and perform their respective functions for the good of the whole organism

• A mutant cell that “refuses” to co-operate may have a selective advantage

• The offspring of such a cell may spread

• This is a beginning of cancer

Page 11: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Progression to cancer

Page 12: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Progression to cancer

Constant population

Page 13: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Progression to cancer

Advantageous mutant

Page 14: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Progression to cancer

Clonal expansion

Page 15: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Progression to cancer

Saturation

Page 16: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Progression to cancer

Advantageous mutant

Page 17: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Progression to cancer

Wave of clonal expansion

Page 18: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Genetic pathways to colon cancer (Bert Vogelstein)

“Multi-stage carcinogenesis”

Page 19: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Methodology: modeling a colony of cells

• Cells can divide, mutate and die

Page 20: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Methodology: modeling a colony of cells

• Cells can divide, mutate and die

• Mutations happen according to a “mutation-selection diagram”, e.g.

(1) (r1) (r2) (r3) (r4)

u1 u2 u3u4

Page 21: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Mutation-selection network

1u1u

4u

1u

(1) (r1) 3uu2

u5

(r2)(r3)

(r4)

(r5)

(r6)

u8

(r7)u8(r1)

u5

u8

u8

(r6)3u

u2

Page 22: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Stochastic dynamics on a selection-mutation network

Page 23: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Number of is i

A birth-death process with mutations

Fitness = 1

Fitness = r >1

u

Selection-mutation diagram:

(1) (r ) Number of is j=N-i

Page 24: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Evolutionary selection dynamics

Fitness = 1

Fitness = r >1

Page 25: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Evolutionary selection dynamics

Fitness = 1

Fitness = r >1

Page 26: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Evolutionary selection dynamics

Fitness = 1

Fitness = r >1

Page 27: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Evolutionary selection dynamics

Fitness = 1

Fitness = r >1

Page 28: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Evolutionary selection dynamics

Fitness = 1

Fitness = r >1

Page 29: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Evolutionary selection dynamics

Fitness = 1

Fitness = r >1

Start from only one cell of the second type.Suppress further mutations.What is the chance that it will take over?

Page 30: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Evolutionary selection dynamics

Fitness = 1

Fitness = r >1

Start from only one cell of the second type.What is the chance that it will take over?

1/1

1/1)(

Nr

rr

If r=1 then = 1/NIf r<1 then < 1/NIf r>1 then > 1/NIf r then = 1

Page 31: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Evolutionary selection dynamics

Fitness = 1

Fitness = r >1

Start from zero cell of the second type.What is the expected time until the second type takes over?

Page 32: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Evolutionary selection dynamics

Fitness = 1

Fitness = r >1

Start from zero cell of the second type.What is the expected time until the second type takes over?

)(1 rNuT

In the case of rare mutations,

Nu /1we can show that

Page 33: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Two-hit process (Alfred Knudson 1971)

1uu

(1) (r) (a)

1r

What is the probability that by time t a mutant of has been created?

Assume that and 1a

Page 34: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

A two-step process1uu

Page 35: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

A two-step process1uu

Page 36: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

A two step process

1uu

Page 37: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

A two-step process1uu

(1) (r) (a)

Scenario 1: gets fixated first, and then a mutant of is created;

time

Num

ber

of c

ells

Page 38: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Stochastic tunneling

1uu

Page 39: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Two-hit process

time

Num

ber

of c

ells

Scenario 2:A mutant of is created before reaches fixation

1uu

(1) (r) (a)

Page 40: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

The coarse-grained description

1210102

1210101

0200100

xRxRx

xRxRx

xRxRx

20R

10R21R Long-lived states:

x0 …“all green”x1 …“all blue”x2 …“at least one red”

Page 41: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Stochastic tunneling

1NuNu

Assume that and 1r 1a

120 uNuR

r

rNuuR

1

120

1|1| ur

1|1| ur

20RNeutral intermediate mutant

Disadvantageous intermediate mutant

Page 42: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Stem cells, initiation of cancer and optimal tissue architecture

Page 43: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Colon tissue architecture

Page 44: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Colon tissue architecture

Crypts of a colon

Page 45: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Colon tissue architecture

Crypts of a colon

Page 46: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Cancer of epithelial tissues

Cells in a crypt of a colon

Gut

Page 47: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Cancer of epithelial tissues

Stem cells replenish thetissue; asymmetric divisions

Cells in a crypt of a colonGut

Page 48: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Cancer of epithelial tissues

Stem cells replenish thetissue; asymmetric divisions

Gut

Proliferating cells dividesymmetrically and differentiate

Cells in a crypt of a colon

Page 49: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Cancer of epithelial tissues

Stem cells replenish thetissue; asymmetric divisions

Gut

Proliferating cells dividesymmetrically and differentiate

Differentiated cells get shed off into the lumen

Cells in a crypt of a colon

Page 50: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Finite branching process

Page 51: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

What is known:• Normal cells undergo apoptosis at the top of the

crypt, the tissue is renewed and cell number is constant

Page 52: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

What is known:• Normal cells undergo apoptosis at the top of the

crypt, the tissue is renewed and cell number is constant

• One of the earliest events in colon cancer is inactivation of the APC gene

Page 53: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

What is known:• Normal cells undergo apoptosis at the top of the

crypt, the tissue is renewed and cell number is constant

• One of the earliest events in colon cancer is inactivation of the APC gene

• APC-/- cells do not undergo apoptosis at the top of the crypt

Page 54: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

What is NOT known:

• What is the cellular origin of cancer?

• Which cells harbor the first dangerous mutaton?

Are the stem cells the ones in danger?

• Which compartment must be targeted by drugs?

?

?

?

Page 55: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Colon cancer initiation

• Both copies of the APC gene must be mutated before a phenotypic change is observed (tumor suppressor gene)

APC+/+ APC+/- APC-/-

X XX

Page 56: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Cellular origins of cancer

If a stem cell tem cell acquires a mutation, the whole crypt is transformed

Gut

Page 57: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Cellular origins of cancer

If a daughter cell acquiresa mutation, it will probablyget washed out beforea second mutation can hit

Gut

Page 58: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

What is the cellular origin of cancer?

Page 59: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Colon cancer initiation

Page 60: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Colon cancer initiation

Page 61: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Colon cancer initiation

Page 62: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Colon cancer initiation

Page 63: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Colon cancer initiation

Page 64: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Colon cancer initiation

Page 65: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

First mutation in a daughter cell

Page 66: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

First mutation in a daughter cell

Page 67: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

First mutation in a daughter cell

Page 68: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

First mutation in a daughter cell

Page 69: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

First mutation in a daughter cell

Page 70: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

First mutation in a daughter cell

Page 71: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Cellular origins of cancer

• The prevailing theory is that the mutations leading to cancer initiation occur is stem cells

Page 72: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Cellular origins of cancer

• The prevailing theory is that the mutations leading to cancer initiation occur is stem cells

• Therefore, all prevention and treatment strategies must target the stem cells

Page 73: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Cellular origins of cancer

• The prevailing theory is that the mutations leading to cancer initiation occur is stem cells

• Therefore, all prevention and treatment strategies must target the stem cells

• Differentiated cells (most cells!) do not count

Page 74: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Mathematical approach:

• Formulate a model which distinguishes between stem and differentiated cells

• Calculate the relative probability of various mutation patterns

Page 75: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

First mutation in a daughter cell

Page 76: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

First mutation in a daughter cell

Page 77: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

First mutation in a daughter cell

Page 78: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

First mutation in a daughter cell

Page 79: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

First mutation in a daughter cell

Page 80: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

First mutation in a daughter cell

Page 81: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Stochastic tunneling in a heterogeneous population

1Nuu

1) At least one mutation happens in a stem cell (cf. the two-step process)

2) Both mutations happen in a daughter cell: no fixation of an intermediate mutant (cf tunneling)

20R 1120 log uNuuR

) .( 1uNuRcf

Page 82: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Stochastic tunneling in a heterogeneous population

1Nuu

1) At least one mutation happens in a stem cell (cf. the two-step process)

2) Both mutations happen in a daughter cell: no fixation of an intermediate mutant (cf tunneling)

20R 1120 log uNuuR

) .( 1uNuRcf Lower rate

Page 83: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Cellular origins of cancer

• If the tissue is organized into compartments with stem cells and daughter cells, the risk of mutations is lower than in homogeneous populations

Page 84: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Cellular origins of cancer

• If the tissue is organized into compartments with stem cells and daughter cells, the risk of mutations is lower than in a homogeneous population

• Cellular origin of cancer is not necessarily the stem cell. Under some circumstances, daughter cells are the ones at risk.

Nuu

1log 11

Page 85: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Cellular origins of cancer

• If the tissue is organized into compartments with stem cells and daughter cells, the risk of mutations is lower than in a homogeneous populations

• Cellular origin of cancer is not necessarily the stem cell. Under some circumstances, daughter cells are the ones at risk.

• Stem cells are not the entire story!!!

Page 86: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Optimal tissue architecture

• How does tissue architecture help protect against cancer?

• What are parameters of the architecture that minimize the risk of cancer?

• How does protection against cancer change with the individual’s age?

Page 87: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Optimal number of stem cells

m=1m=2

m=4m=8

Crypt size isn=16

Page 88: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Probability to develop dysplasia

Time (individual’s age)

Pro

babi

lity

to d

evel

op d

yspl

asia

One stem cell

Many stem cells

Page 89: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

The optimal solution is time-dependent!

Time (individual’s age)

Pro

babi

lity

to d

evel

op d

yspl

asia

Optimum:one stemcell

Optimum:many stem cells

Many stem cells

One stem cell

Page 90: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Optimization problem

• The optimum number of stem cells is high in young age, and low in old age

• Assume that tissue architecture cannot change with time: must choose a time-independent solution

• Selection mostly acts upon reproductive ages, so the preferred evolutionary strategy is to keep the risk of cancer low while the organism is young

Page 91: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Evolutionary compromiseP

roba

bili

ty to

dev

elop

dys

plas

ia

Time (individual’s age)

One stem cell

Many stem cells

Page 92: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

While keeping the risk of cancer low at the young age, the preferred evolutionary strategy works against the older age, actually increasing the likelihood of cancer!

Evolutionary compromiseP

roba

bili

ty to

dev

elop

dys

plas

ia

Time (individual’s age)

One stem cell

Many stem cells

Page 93: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Cancer vs aging

• Cancer and aging are two sides of the same coin…..

Page 94: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Drug therapy and generation of resistance

Page 95: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Leukemia

• Most common blood cancer

• Four major types:

Acute Myeloid Leukemia (AML),

Chronic Lymphocytic Leukemia (CLL),

Chronic Myeloid Leukemia (CML),

Acute Lymphocytic Leukemia (ALL)

Page 96: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Leukemia

• Most common blood cancer

• Four major types:

Acute Myeloid Leukemia (AML),

Chronic Lymphocytic Leukemia (CLL),

Chronic Myeloid Leukemia (CML),

Acute Lymphocytic Leukemia (ALL)

Page 97: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

CML• Chronic phase (2-5 years)

• Accelerated phase (6-18 months)

• Blast crisis (survival 3-6 months)

Page 98: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Targeted cancer drugs

• Traditional drugs: very toxic agents that kill dividing cells

Page 99: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Targeted cancer drugs• Traditional drugs: very toxic agents that kill

dividing cells

• New drugs: small molecule inhibitors

• Target the pathways which make cancerous cells cancerous (Gleevec)

Page 100: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Gleevec: a new generation drug

Bcr-Abl

Page 101: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Gleevec: a new generation drug

Bcr-Abl Bcr-Abl

Page 102: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Small molecule inhibitors

Page 103: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Targeted cancer drugs

• Very effective

• Not toxic

Page 104: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Targeted cancer drugs

• Very effective

• Not toxic

• Resistance poses a

problem

Bcr-Abl protein

Gleevec

Page 105: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Targeted cancer drugs

• Very effective

• Not toxic

• Resistance poses a

problem

Bcr-Abl protein

Gleevec

Mutation

Page 106: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Treatment without resistance

time

treatment

Page 107: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Development of resistance

treatment

Page 108: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

How can one prevent resistance?

• In HIV: treat with multiple drugs

• It takes one mutation to develop resistance of one drug. It takes n mutations to develop resistance to n drugs.

• Goal: describe the generation of resistance before and after therapy.

Page 109: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Mutation network for developing resistance against n=3 drugs

Page 110: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

During a short time-interval, t, a cell of type Ai can:

• Reproduce faithfully with probability

Li(1-uj) t

Page 111: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

During a short time-interval, t, a cell of type Ai can:

• Reproduce faithfully with probability

Li(1-uj) t

• Produce one cell identical to itself, and a mutant cell of type Aj with probability Liuj t

Page 112: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

During a short time-interval, t, a cell of type Ai can:

• Reproduce faithfully with probability

Li(1-uj) t

• Produce one cell identical to itself, and a mutant cell of type Aj with probability Liuj t

• Die with probability Di t

Page 113: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

The method

]))((1)[()1()1(

])1)[(()1()1)(()(

ij1ji,j1,i

1-ji,j1,-iij

tjiDLttDjtDi

tiLuLjttuLittt

DyDLLuxyuLy

DxDLLxxt

)]([)1()( 22

Assume just one drug. ij(t) is the probability to have i susceptible and j resistantcells at time t.

x,y;tij(t)xjyi is the probability generating function.

))()(()1()1(

])1)[(()1()1)((

ij1ji,j1,i

1-ji,j1,-iij

jiDLtDjDi

iLuLjtuLit

Page 114: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

The method

]))((1)[()1()1(

])1)[(()1()1)(()(

ij1ji,j1,i

1-ji,j1,-iij

tjiDLttDjtDi

tiLuLjttuLittt

))()(()1()1(

])1)[(()1()1)((

ij1ji,j1,i

1-ji,j1,-iij

jiDLtDjDi

iLuLjtuLit

ij(t) is the probability to have i susceptible and j resistantcells at time t.

x,y;tij(t)xjyi is the probability generating function.

.)]([)1(

;)(2

2

DyDLLuxyuLy

DxDLLxx

Page 115: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

For multiple drugs:

niDxDLLiuxxiuLx

DxDLLxx

iiii

0 ,)]([)1(

;)(

12

02

00

i0, i1, …, im(t) is the probability to have is cells of type As at time t.

x0,x1,…,xm;ti0, i1, …, im(t) x0im …xm

i0

is the probability generating function.

0,1,…,1;tis the probability that at time t there are no cells of type Am

0,0,…,0;tis the probability that at time t the colony is extinct

Page 116: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

The method

.0)0(

,0 ,)]([)1(

;)(

12

02

00

i

iiii

x

niDxDLLiuxxiuLx

DxDLLxx

he probability that at time t the colony is extinct is (0,0,…,0;t) =xn

M(t),

where M is the initial # of cells and xn is the solution of

The probability of treatment failure is

)(lim1 txP Mntfail

Page 117: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

The questions:

1. Does resistance mostly arise before or after the start of treatment?

2. How does generation of resistance depend on the properties of cancer growth (high turnover D~L vs low turnover D<<L)

3. How does the number of drugs influence the success of treatment?

Page 118: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

1. How important is pre-existence of mutants?

Page 119: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Single drug therapy

Page 120: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Single drug therapy

Pre-existance = Generation during treatment

Page 121: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Single drug therapy

Pre-existance = Generation during treatment

Unrealistic!

Page 122: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Single drug therapy

Pre-existance >> Generation during treatment

Page 123: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Multiple drug therapies

Fully susceptible

Fully resistant

Partially susceptible

Page 124: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Development of resistance

Fully susceptible

Partially susceptible

Fully resistant

Page 125: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

1. How important is pre-existence of resistant mutants?

For both single- and multiple-drug therapies,

resistant mutants are likely to be produced before start of treatment, and not in the

course of treatment

Page 126: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

2. How does generation of resistance depend on the turnover

rate of cancer?

• Low turnover (growth rate>>death rate)

Fewer cell divisions needed to reach a certain size

• High turnover (growth rate~death rate)

Many cell divisions needed to reach a certain size

Page 127: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Single drug therapy

Low turnover cancer, D<<L

Page 128: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Single drug therapy

High turnover cancer, D~L

More mutant colonies are produced, but theprobability of colony survival is proportionally smaller…

Page 129: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

2. How does generation of resistance depend on the turnover

rate of cancer?

• Single drug therapies: the production of mutants is independent of the turnover

Page 130: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

2. How does generation of resistance depend on the turnover

rate of cancer?

• Single drug therapies: the production of mutants is independent of the turnover

• Multiple drug therapies: the production of mutants is much larger for cancers with a high turnover

Page 131: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

3. The size of failure

• Suppose we start treatment at size N

• Calculate the probability of treatment failure

• Find the size at which the probability of failure is=0.01

Page 132: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

3. The size of failure

• Suppose we start treatment at size N

• Calculate the probability of treatment failure

• Find the size at which the probability of failure is=0.01

• The size of failure increases with # of drugs and decreases with mutation rate

Page 133: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Minimum # of drugs for different parameter values

1013 cells

u=10-8-10-9 is the basic point mutation rate, u=10-4 is associated with genetic instabilities

Page 134: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Minimum # of drugs for different parameter values

1013 cells

u=10-8-10-9 is the basic point mutation rate, u=10-4 is associated with genetic instabilities

Page 135: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Minimum # of drugs for different parameter values

1013 cells

u=10-8-10-9 is the basic point mutation rate, u=10-4 is associated with genetic instabilities

Page 136: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Minimum # of drugs for different parameter values

1013 cells

u=10-8-10-9 is the basic point mutation rate, u=10-4 is associated with genetic instabilities

Page 137: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Minimum # of drugs for different parameter values

1013 cells

u=10-8-10-9 is the basic point mutation rate, u=10-4 is associated with genetic instabilities

Page 138: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

CML leukemia

• Gleevec

• u=10-8-10-9

• D/L between 0.1 and 0.5 (low turnover)

• Size of advanced cancers is 1013 cells

Page 139: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Log size of treatment failure

(a) 1 drug 2 drugs 3 drugs 4 drugs 5 drugs D/L=0.1 5.95 12.34 18.45 24.38 30.19 D/L=0.5 5.95 12.13 17.99 23.69 29.26 D/L=0.9 5.95 11.48 16.70 21.74 26.66 (b) 1 drug 2 drugs 3 drugs 4 drugs 5 drugs D/L=0.1 4.00 8.55 12.80 16.89 20.86 D/L=0.5 4.00 8.31 12.37 16.20 19.93 D/L=0.9 4.00 7.68 11.07 14.40 17.40

u=10-8

u=10-6

Page 140: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Application for CML

• The model suggests that 3 drugs are needed to push the size of failure (1% failure) up to 1013 cells

Page 141: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Conclusions

• Main concept: cancer is a highly structured evolutionary process

• Main tool: stochastic processes on selection-mutation networks

• We addressed questions of cellular origins of cancer and generation of drug resistance

• There are many more questions in cancer research…

Page 142: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer
Page 143: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer
Page 144: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer
Page 145: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Multiple drug treatments

• For fast turnover cancers, adding more drugs will not prevent generation of resistance

Page 146: Natalia Komarova (University of California - Irvine) Somatic evolution and cancer

Size of failure for different turnover rates