Figure 2. Potential cancer therapies inspired by mechanisms of extinction.

Lessons from paleontology have taught us that one selective pressure is not enough to successfully attack cancer, but rather that multiple selective pressures are necessary, targeting the tumour from different directions. The multiple pressures could target the different microenvironments in a spatially heterogeneous tumour. Further paleontology also suggests that we should apply combinations of chemotherapy, adaptive therapy, anti-angiogenic therapy, hyperthermia, bacteriolytic therapy, and targeted therapy over long periods, without breaks, to maintain selective pressures on the neoplastic cells, as it is done with metronomic therapies.